Despite being a relative newcomer to dentistry, Shaadi Manouchehri is fast gaining a name as one of the industry’s prolific young talents.

Fellow podcaster Shaadi shares the secrets behind her meteoric rise on social media; talks candidly about her rocky start in dentistry with a VT role from hell and lets us in on how her guide to getting into dental school became a surprise hit.

Enjoy!

“I’ve learned a lot about other people and their experience doing the podcast. I genuinely enjoy them. So, similar to what you were saying, it’s like you’re having a conversation and you just happen to press record.”  – Shaadi Manouchehri

In This Episode

01.18 – Backstory
03.12 – I’m going to be a dentist
05.55 – How to Get into Dental School
08.15 – Life at Queen Mary
11.01 – Into VT
13.49 – The job from hell
19.02 – Greener grass
21.07 – Teeth and Tales
29.47 – Social media
38.45 – Productivity
42.45 – Black box thinking
43.52 – The dark side of social
47.47 – The plan
52.12 – Women in dentistry
56.54 – Last day and legacy

About Shaadi Manouchehri

Shaadi Manouchehri graduated with BDS honours from Barts and the London School of Dentistry before completing training in oral and maxillofacial surgery at the Royal Free London NHS Foundation Trust.

She also has completed dental foundation training in North East London, followed by training in paediatric and restorative dentistry at Guy’s and St Thomas’ NHS Foundation Trust.

Shaadi is a prolific author whose writing appears in the British Dental Journal. She is CEO and co-founder of the Dentappy online dental platform and committee member of the Iranian Medical Society charity. 

Shaadi is also the host of Teeth and Tales podcast.

Shaadi: I think the biggest mistake I made was to chase down that job. So, I think it’s taught me when to stop chasing stuff. You have to be persistent if you want to get things done. But at the same time, if stuff isn’t happening organically, then there’s a reason. So, leave it well alone. I think that’s the greatest lesson that I’ve learned. The mistake from taking a job that I shouldn’t have.

Speaker 2: This is Dental Leaders. The podcast where you get to go one-on-one with emerging leaders in dentistry. Your hosts, Payman Langroudi and Prav Solanki.

Payman: It gives me great pleasure to welcome Shaadi Manouchehri onto the podcast. Young dentist, qualified five years now, and I’d say one of the new breed of inverted content creators that we’re seeing come through. Most of them are younger than you, Shaadi. It’s good to have you. Thanks for coming. Shaadi, you’ve done a lot in your short career, and you just ooze confidence the way I see it, in front of the camera and all of that.

Payman: Where does it come from? Tell us about your childhood. Where did you grow up? Were you one of these drama types? Or, what happened?

Shaadi: First of all, I’m so privileged and honoured to be on your podcast, and I’m so glad to be on this side, for a change. Because, I can relax and I don’t have to think of the questions. But yeah, thank you for that. That’s a great introduction. I actually, I’ve always been fairly outspoken, and friendly and out there. But, I’ve never been into drama or anything like that. I actually grew up in Iran. I was born in London, but I moved back when I was around one month old. And then I came back when I was 11.

Shaadi: It was a difficult time, because I didn’t speak English and I went straight to school. So, it was a strange experience, going from someone who was used to being with a lot of people, being very outspoken, coming to a place where I couldn’t speak to anyone. So I kind of stood there. I remember I would sit in the front row, and for a whole month, I couldn’t say anything, because I didn’t understand anything, because I was just absorbing the information. Then, I think when you’re young, you pick up the language really quickly. So, I learned really quickly, and I started talking and I haven’t stopped since.

Shaadi: But, in terms of content creations and things, that’s something that’s fairly new to me as well. I think my social media platforms are under a year old, so they’re still very, very new. But I was lucky that I was able to dedicate a lot of time and attention to them, and really make them what I wanted them to become. So, I think I’ve been sort of lucky. But also, there’s a lot of time, and effort and planning that goes into it. I think with practise, it just gets a little bit better. So, just because I’ve spent a lot of time doing it, so a year might not be a very long time.

Shaadi: But, in that year, I’ve spent a lot of time just going over stuff, learning from my mistakes, I’ve made those mistakes. But just learning from those and then just trying to improve and get better.

Payman: Tell me about the first time you thought, “I’m going to be a dentist.” How did that happen?

Shaadi: It’s been a long time ago.

Payman: It was not that long ago. You were, what? 11 when you got here.

Shaadi: Yeah.

Payman: And then-

Shaadi: So I always liked going to the dentist, since I was little. Again, I’m lucky that my mom in particular, she placed a lot of emphasis on looking after yourself, brushing your teeth. I remember having to brush our teeth every night, every morning, going to the dentist regularly, that kind of thing. So it was always a big thing. It was always a very important thing. And I always had really, really positive experiences at the dentist. I had a nice dentist, and I didn’t need any major treatment. So, I always had good memories.

Shaadi: Then, when I moved here, I was a big fan of science. I think science and maths were ingrained into my Persian brain. And when the time came for me to apply, my brother was studying medicine so I was kind of like, “Okay, do I want to study that?” And pretty much straight away I was like, “No.” And, that’s a decision that I’ve never ever regretted. But I was like, “Okay, what else is close to that that I like and I think it’s going to be practical?” Because, I was quite artsy as well. I liked making things, creating things.

Shaadi: So, dentistry was ideal, sounded ideal. So I did work experience, and then the more I looked into it, the more interesting it became, and I applied. I think when I did my max fac job probably I regretted my decision. But since then, I don’t think I’ve regretted my decision. [crosstalk 00:04:37]-

Payman: It’s a big theme that keeps coming up on your content that I see. The medicine or dentistry.

Shaadi: Yeah.

Payman: Is that because these days it’s the same rates for both? Because, back in my day, it wasn’t really both. Either you could get into medicine or you couldn’t. You know? It was one of those.

Shaadi: Yeah.

Payman: Why is it such a big theme in your content?

Shaadi: Because, to be honest, I think when I applied it wasn’t a big thing. Because, I purely considered it because my brothers were all studying it, and it was the closest thing I had to anyone close to me studying a sciency kind of subject. So, for me it wasn’t a big deal. But, a lot of the feedback I’ve been getting, because since I started creating the content, a lot of prospective dental applicants have reached out to me, asked questions. And the recurring theme is medicine or dentistry. And to be honest, I don’t think they’re similar at all. You know?

Payman: No.

Shaadi: A career in medicine is completely different to a career in dentistry. But, the feedback that I’ve been getting from these prospective applicants is that they’re considering both. So that’s mainly why I spend a lot of attention to it. And I think because I have a lot of, obviously friends and family who are medics, I ask them and I try and understand what’s different about medicine and dentistry and draw the pros and cons to share with other people or help them to decide. Raise points that’s going to help them decide.

Payman: And you actually wrote a book on how to get into dentistry.

Shaadi: I did. Yeah. That was my lockdown. One project. Yeah. I’m not one to stay idle for long.

Payman: Tell me about it.

Shaadi: I’m not one to stay idle for long. To be honest, I’ve always loved writing. I’ve loved writing. And, since I qualified, I spent a lot of time and effort trying to get published in different journals, and like on video blog and that kind of thing. So I had a lot of articles go out, and the more I wrote, the more I liked writing. And then, when I started this whole TikTok thing in lockdown, there was a lot of people asking me about, “What do I do to get into dentistry?” And there’s a lot of things to consider.

Shaadi: I certainly didn’t know it. Like I said, when I moved here, I didn’t know anyone who was applying to dentistry. My brother didn’t know anyone who was applying to medicine. So we kind of had to learn things by ourselves, which was really, really difficult. Things that are obvious to me now, like you have to have extracurricular stuff. You have to do this, that. I didn’t know any of that before. So, I was like, “Okay, I’m going to do something.” And a lot of people were reaching out saying, “What do I do? How do I show manual dexterity?” That kind of stuff.

Shaadi: And I would reply to every single one of them, because it was lockdown and I wasn’t doing anything. So I would write these lengthy messages back to them saying exactly what they needed to do. And then I kind of realised that actually all these people that are sitting at home, and they should be studying, they should be at school, but they have all this free time. Instead of me just copy and pasting the same thing, why don’t I actually make a thing of it? So the idea was to write an eBook first, and then it evolved from there and it became an actual physical book.

Payman: Even that happened in lockdown as well.

Shaadi: Yeah.

Payman: So this lockdown’s been a big thing for content creators.

Shaadi: Yeah. I think we finally had the time. People finally had the time to do stuff. Because I think you get so bogged down with clinical dentistry. And, when you’re not at the clinic, you’re having to catch up with admin, that kind of stuff. So I think when we had those, was it, what?

Shaadi: Three months, from March until June, I think a lot of us got to spend time on the stuff that we’d always wanted to do. I’m a big believer that something starts from somewhere and it ends up something completely different. So, I’m really proud of that, actually, I’m happy that it got published and it’s available on Amazon. I had a lot of good feedback from it.

Payman: What’s it called? How to Get Into Dental School?

Shaadi: How to Get Into Dental School? Yeah.

Payman: Creative.

Shaadi: What it says on the thing.

Payman: Where did you study dentistry, yourself?

Shaadi: Queen Mary. So, Barts and the London. And, I remember I wanted to-

Payman: How was your experience?

Shaadi: It was good. My experience was very, very good. I knew I wanted to stay in London, because I wanted to be close to my family. So it was either King’s or Queen Mary. And, I applied to both. Queen Mary has a much smaller group, so I think there was 60 of us in one year. Whereas at King’s it’s like 200 or something. So it was nice. It was a very strange area. Whitechapel and Mile End just definitely takes some getting used to. But, I was lucky I had a good year group.

Shaadi: I had a group of close friends in the year. So, it was a good experience. We travelled a lot. I struggle in my first year a bit. Because, I found it difficult to adapt. And I often talk about this. Because, you go from, you know, at school we’re used to doing really, really well. So, I was used to being … I was involved in the student body. I was involved in all sorts of different things. I would always get top grades. So I was used to being kind of …

Payman: Top dog.

Shaadi: Kind of. I don’t want to say top dog, but it was like you’re teachers’ favourites because you do your work. That kind of thing. And then you go from that environment to somewhere where everyone else is exactly like you, so you’re not special anymore. Everyone has three As and A star. Everyone plays the guitar or the piano. So, I found that slightly difficult to adapt to my first year. But, after I got the hang of it, from second year on it was a much nicer experience.

Payman: Yeah. I caught one of your podcasts. It was a post. You were saying, “Don’t study too hard like I did.”

Shaadi: Yeah. Definitely. Definitely. Because, I think what … There’s a lot of emphasis on mental health, I think now, but even back … So, I started studying in 2010, and back then nobody was talking about mental health. Nobody was talking about stress, or OCD, or anything, or anxiety. All this kind of stuff that’s almost become trendy now and everyone talks about it. Back in 2010, no one spoke about it, and I was spending all my time and energy studying.

Shaadi: So I would come home, I would revise. I wasn’t eating very much. I wasn’t socialising a lot. I was really, really stressed, really, really stressed. So, I did really badly in my exams. I had to retake most of my exams, even though I was studying a lot. Something didn’t make sense to me. And then, my brother is the person I go to when I’m stressed. And he explains things really nicely to me. He was like, “Look, you’re like a car without fuel, and you can’t run. So, you have to take care of yourself. You have to put yourself first. And then once you’re well, then you can start studying.”

Shaadi: So I did that. So from second year onwards, I made sure I was eating well. I was kind of socialising. And, I was well, and I was studying much less actually, and I did so much better in my exams. I did much, much better in my exams from second year onwards.

Payman: And then, when you became a dentist, what were you thinking? What kind of dentist were you thinking you want to be back then? So you said you had a max fac job.

Shaadi: Yeah, so when I qualified, I had no idea what I wanted to do, but I kind of was going with the flow. So, when I did my VT, I did my VT in East London. And then, the time came for to applying for DCT, dental core training, and I applied and I was like, yeah I got a very, very good posting. I got dental core training in paediatrics and restorative dentistry at Guy’s. In peds, there weren’t very, very many peds posts, so everybody who wanted to do orthodontics was looking for a peds post.

Shaadi: So when I did peds, I was like, “Okay, maybe I want to do ortho.” So then, I was like, “Okay, let’s just apply to DCT two, see what happens.” And I applied, and I was very lucky that I got max fac at the Royal Free Trust. Royal Free is a hospital that’s very local to me and I was like, I would only do max fac if it’s at the Royal Free. So I got max fac at the Royal Free. But, little did I know that actually max fac is based at two other hospitals. So, they’re far away from me.

Shaadi: Chase Farm and Barnet. They were further away. Still drivable, but far away. So, once I did peds and max fac, I was like, “Okay, maybe I want to do ortho.” I’m the kind of person that goes with the flow. So if everybody else is applying, I’ll apply as well, just to test myself. I applied to ortho, and the year that I applied, I think there was like a ridiculous number posts. There was like 18 posts for like so many applicants. So I didn’t get in. A lot of my friends didn’t get in.

Shaadi: I took a few months off to recover, and I was like, “Okay, I’ll go into practise and then I’ll reapply next year.” But actually, I went into practise and I loved it so much that the time for applications came next year, and I just didn’t apply. I was like, “I’m happy doing what I’m doing,” and it just kind of went from there.

Payman: Sort of mixed factors.

Shaadi: Yeah. Mixed factors. But I think I got really, really lucky with the practise that I’m in. We’re like a family, and the principal dentist, he reminds me a lot of my dad. He’s like a mentor. So I remember the first day that I started, and he called me into his room and he was like, “How was it? What went well? What didn’t go well?” Because, obviously I had come from two years of being in a hospital.

Shaadi: I didn’t know anything about practise. And even though at the interview, I was like, “I’m great at doing extractions, this that,” I obviously didn’t know how to do general day-to-day dentistry stuff. He was a big part of me learning, and my development. I’ve been there now for two years, and I’ve evolved so much. Put it down to the team I have.

Payman: And you’ve only ever been in that practise, apart from certain others as well-

Shaadi: Yeah. That’s been my main practise. I’ve done locum shifts here and there, and I started a job that was horrible, and I was there for three months. But, yeah, that’s been the main place that I’ve been now for the past two years.

Payman: Tell me about the horrible job.

Shaadi: Where do I start? So, this was a job. The practise that I’m in now, I’m there two or three days a week. So, part-time. When I, sort of a year and a half ago, my mentality was that I need to be working 24-7, six days a week. I’m still very new out of dentistry. I still am young and I don’t have too many commitments, in terms of family and that kind of thing. So I want to be working as much as I can to learn as much as I can, earn as much as I can and then slow down whenever I need to. So, I applied to this job that was at a very, very nice fully private practise that looked really nice. MacBooks everywhere.

Shaadi: It was actually very, very local to me. Nice affluent area of London. So it seemed ideal. And I applied, I think it was in March. And I got called in for an interview, and I went in. Then they called me in for a second interview, and I was actually away at the time, so I kind of messaged in saying, “Sorry, I can’t make this. Can I come at a different time?” And they just never got back to me.

Shaadi: I kept chasing, I kept calling, emailing and that kind of thing. They just didn’t get back to me. Then three months later, that same job came up again, and I applied to it again. And, I got the job, eventually. When I started, it became apparent very quickly that it was a very bad practise. Without going into too much details, because I think a lot of people will know where it is. It was just a very, very bad, toxic environment with people who had no insight.

Shaadi: The practise manager was telling me what to do clinically. He was nowhere near a clinical. And, I think it was after 10 days that I handed him my notice.

Payman: Wow.

Shaadi: But unfortunately, because of the contract, I had to stay there for three months. So imagine somewhere that I couldn’t even last 10 days, I had to stay for three months. So, it was a horrible time, horrible, horrible time. And I was very unwell, because I was working six days a week, 12 hours a day. So, the way I was working was that I would do kind of eight to two, or two to eight. And then, I made a very, very wise decision to ask my principal to not fill my job at that practise until I’d sort of tested the waters at the other practise.

Shaadi: He was kind enough to say, “Okay, I’ll give you four weeks or a month to see what you want to do.” But obviously, it wasn’t ideal for them, because I was there maybe a few hours a day, if that. So, all my patients were suffering and that kind of thing. So, that’s why I’m so grateful to my team and my principal at my current practise, because they’ve been through a lot with me.

Payman: Yeah, but look, you didn’t get along with the practise manager, yeah?

Shaadi: It was just everything. The principal.

Payman: I get that. Do you think in hindsight, there were signs that you could have seen? Did you sort of paper over something because you thought it was a private practise or whatever?

Shaadi: Yeah. Definitely.

Payman: So what were those things?

Shaadi: Definitely. So the person that was working there before me was someone that I knew from VT. I didn’t know him very well, but he kind of gave me some hints. He was like, “Look, there are some things that aren’t right here, but your experience might be different.” I was very naïve in thinking, okay well different people are different. I respect this person. I respect his opinion, but everyone might be different in different practises. But, luckily, the warning that he gave me made me not completely leave my old job. But yeah, definitely, everyone that was working there was working their three month notice. Nurses, the dentists.

Shaadi: And, they had two surgeries, and one of those surgeries was filled part-time. So, they were maybe 30, 40 percent of their capacity, and that should have been a warning sign. But, that job keeps coming up again and again. Literally, every three months it will come up. So …

Payman: A lot of times, you know, with your first few jobs, there is that sort of side of you learn what not to do. You learn what’s wrong with things as well as what’s right with things.

Shaadi: Yeah.

Payman: But, if you had to put it down to what was the actual cause of the problem in this practise, would you say it comes from the top? The principal?

Shaadi: There was a lot. I think there was lack of insights, in terms of management. There was lack of insights, in terms of they didn’t understand. I don’t think they had the right perspective in seeing things the right way. I think they trained their patients to be ridiculous, in terms of their expectations.

Shaadi: Like, patients would have hygiene appointments, and they would come out and the practise manager would say, “How was your hygiene? Was it painful?” Why would you say that to a patient? Like the way, just everything. The way they treated their staff. They treated their nurses very, very badly, and their team. I’ve learnt from then what I’m willing to compromise. Because, no job is perfect. I’ve learnt this time and time again. But I think there are certain things that you shouldn’t compromise. For me, it’s the environment that I’m working in.

Shaadi: If it’s a very negative, controlling environment, toxic environment, then I’m not going to be there. Because, dentistry is stressful enough as it is. You’re going to make clinical mistakes. But, if you’re in an environment that doesn’t support you or focuses on the negatives, then you’re not going to grow and it’s only going to be downhill. It’s taught me what things to compromise on and what things are absolutely not compromisable, if that’s a word.

Payman: So your other job sounds like the exact opposite, right?

Shaadi: Yeah.

Payman: Because, I see you on TikTok laughing together.

Shaadi: Yeah.

Payman: In the garden, is it a garden there?

Shaadi: Yeah. It’s a house that was converted to a practise, so we have a garden and we have very nice surgeries. But, see, because I’m very sensitive to my atmosphere and my environment. So if I’m happy, I do well. If I’m unhappy, I don’t do well. I know that’s not a positive to have. It’s not a good character trait to have. But, it’s me. I spoke to my dad about this and I was like, “Look, what do I do?” And he was like, “Look, it’s unusual to like your job, so you’re very lucky to like the environment that you’re in, like your team, have very minimal stress in the environment that you’re in. So, you’re lucky, but it doesn’t mean that that’s the norm. Usually, it can be quite different.”

Shaadi: So, I’ve learnt from that experience to trust my gut instincts. But, yeah, at this practise, we’re like a family. When I make TikTok videos. Like when we went back from lockdown, everybody wanted to know about my TikTok. They wanted to film TikToks. If something goes wrong, it’s not a blame culture. It’s a question of, “Okay, how can we fix this?” And it’s always about growth, and what can we do together to make things better?

Shaadi: And I’ve grown and evolved a lot since then. I was actually reflecting on how far I’ve come from when I started. I was scared of doing Invisalign. I was scared of doing any kind of treatment really. And now, I know that my principal is next door, so I just have … Even last week, he came in and helped me with a crown prep. Because, we’re very lucky we have an in-house lab, and a lab technician comes in and helps. So it’s like a team, and I think I’m growing a lot more there than I would anywhere else.

Payman: Let’s shout out. What’s his name, your principal?

Shaadi: Professor Basharat. Dr. Basharat.

Payman: Of course. Right.

Shaadi: He reminds me a lot of my dad.

Payman: Fellow countryman.

Shaadi: Yeah. But, do you know what? I don’t think that has anything to do with it. A lot of people say is it because that everyone’s Iranian in the practise and I’m like, “No. It’s got nothing to do with it.”

Payman: Is everyone Iranian?

Shaadi: Most people are. Not everyone, though. We’re a very mixed team. But, the principal is, the principal is.

Payman: I was going to say, that’s going to make for a very interesting situation if everyone’s Iranian. Tell me, look, I’m amazed at your progress when it comes to the content side.

Shaadi: Thank you.

Payman: To say that it all started in lockdown just makes me just … It blows me away. Because, you’ve got your podcast. We should talk about that Teeth and Tales.

Shaadi: Mm-hmm (affirmative).

Payman: I’m doing a podcast. Yours is very clearly, directly more aimed at consumers, at patients.

Shaadi: Yeah. Mine is fairly airy-fairy compared to yours. Yours is very deep and ethical.

Payman: No, no, no. Yours is probably more valuable, because patients need the information. But, I’ve noticed you’re half … Kind of at the beginning, you talk about the person and their career, and then you switch to patients.

Shaadi: Yeah.

Payman: And it’s cool. It’s a cool thing. I recommend everyone to check it out. Teeth and Tales.

Shaadi: Thank you.

Payman: I was a guest on there myself.

Shaadi: Yeah. It’s one of my favourite episodes.

Payman: Mine too. [inaudible] But, my point is this, yeah. That I think it’s super valuable, as long as it comes up in a search. So, let’s say you do an issue on teeth whitening, and when it’s searched on Google or whatever, it comes up, and that’s a really key important point to work out that that happens. You know?

Shaadi: Mm-hmm (affirmative).

Payman: I’m sure you’re on it. But, that’s definitely a thing to do.

Shaadi: I need to do that. Yeah.

Payman: Yeah. Because, otherwise, pointing it to the public’s all well and good. But, if it doesn’t do that, you’ve lost half the trick there.

Shaadi: Yeah.

Payman: But, what I find with podcasts, I find it just super interesting, and just a valuable thing to do. Like, if me and you were sitting in a café, we could be having this conversation and it could be a … Let’s say we’re sitting together for one hour having the coffee. That’s a valuable hour. It happens that we’re recording it now, and God willing a few people will listen to this. But, that doesn’t matter, right? Because, as you know, when you were doing the first one, you had no idea if anyone was going to listen to it.

Shaadi: Yeah. It’s really scary.

Payman: I don’t know about you. I find I keep telling people to start a podcast. Loads and loads of people should do podcasts. What are your thoughts on it?

Shaadi: I am a big fan of podcasts. I’m a big fan of consuming podcasts, because I think it makes me feel really intellectual, and it makes me feel like I’m learning stuff. No, but seriously, if you’re listening to a podcast on your commute to work. I listen to a lot of mental health podcasts, a lot of positive psychology podcasts, and whenever I, say if I’ve listened to that on my morning commute to work, I generally have a better day.

Shaadi: I try and focus on the stuff that I’ve been reminded of. And, I don’t know. I find some people’s voices soothing. Like I want to listen to them. It calms me down, regardless of what they’re saying. And, when I started my podcast I was like, “Who’s going to listen to it?” But actually, I listen to a lot of mental health podcasts, and there is a coach and hypnotherapist that I listen to. She’s British, and she has a very calming British accent. I listen to her a lot.

Shaadi: And then I was like, “Okay, let me check out all these other podcasts on mental health.” I listened to, I think there was this American lady who was very loud. Just, I just didn’t enjoy it, and I switched it off straight away. So, I think there’s a voice, and a person, and a style for everyone. So, depending on what your preference is, I think there’s space for everyone to be out there.

Payman: Yeah, I think each podcast finds its sort of audience, doesn’t it?

Shaadi: Yeah, exactly. Yeah.

Payman: So, I see you get lots of comments and things that you post on Instagram. Are you finding most of the people who listen to yours are patients, or are you finding quite a lot of dentists?

Shaadi: It’s a combination. It’s a combination. I think it’s ideal for patients and prospective dental applicants. And also, dentists in general, young dentists. I think people around my stage that enjoy listening to other people’s experience. So, you kindly mentioned that the podcast is divided into two parts. So usually we have a topic that we talk about. For example, we spoke about teeth whitening.

Shaadi: And then the first part of the podcast is about the guest, and their journey, and the mistakes they made, the lessons that they learned. Because, I think it’s so valuable to talk about that. Because, we see all these people who are very polished and famous on Instagram. But actually, we don’t know about the struggles that they’ve had up until that point. So I think it’s really valuable.

Shaadi: And I’ve learned a lot about other people and their experience doing the podcast. I genuinely enjoy them. So, similar to what you were saying, it’s like you’re having a conversation and you just happen to press record. So, I really enjoy it. I really, really enjoy it.

Payman: So were you inspired by those mental health ones to start your own. I mean, it’s quite a big step. When me and Prav did it … Prav can’t join us this time. But, when me and Prav did it, we’d been talking about it for a couple of years. We were talking about doing separate ones. At the end of the day, me and Prav have got businesses where a content marketing approach, it makes sense. Right?

Shaadi: Yeah.

Payman: It makes sense for us to be out there. But, to do one for patients, I like sort of the way of thinking. Were you worried about it before you started?

Shaadi: Yeah. Of course I was worried. I didn’t know what I was going to talk about. I didn’t know if I was going to be awkward. I didn’t know how it would sound. I didn’t want to sound whiny. But, the way it started was that I was making TikTok videos, and the majority of TikTok videos that I make are pointing to staff or my main lip syncing, and that kind of thing. And then I made this one video about caries and what decay is, and I spoke about it.

Shaadi: A lot of people were commenting and saying, “You have a soothing voice. Please make a podcast. If you had a podcast, I’d listen to it.” That kind of planted the seed in my brain. And it just kind of went from there. Because, I was like, there’s all these people that think dentists are scary things. But actually, if they do find me calming, if they do find my voice calming, or they feel they can trust someone, it’s a good thing to talk about this. And one of the early episodes was anxiety, dental anxiety and what we can do about it.

Shaadi: And, I’ve got a lot of messages from people saying, “Thank you. Your podcast helped me go to the dentist or overcome my anxiety.” I think it’s important for them to listen to stuff. Because, a lot of stuff that’s obvious to us, patients don’t actually know. Like what decay is, what fillings are. That kind of thing. I think it’s important to talk about it in layman’s terms and not be lecturing them and saying, “Sugar is bad.” And I’ve made a point to say, “I love sugar. I have Haribos all day every day.”

Payman: Yeah. Then it’s just, yeah. [crosstalk]

Shaadi: You know? I think they need to understand that we’re people as well. We’re not going to judge them. I’ve had a lot of positive feedback. I tell the majority of my own patients to listen to them as well. So, if it’s about some treatments, I tell them to listen to the podcast, and I find that a bit awkward, to be honest. But, it has gotten easier.

Payman: Have you had patients come and find you after listening to your podcast to say, “I want you to be my dentist”?

Shaadi: Not specifically after podcast. I think as a combination of the social media presence, yes. I don’t know if it’s down to podcast purely. I think it’s a combination.

Payman: Do you get DMs TikTok saying, “I want you to be my dentist”?

Shaadi: Yes. A lot of people comment saying that, and a lot of people message asking questions, like very detailed, specific questions. I used to spend time replying to every single one. But, now I’m just like at the sheer volume, I can’t get back to all of them. So I’m like, “Look, it’s clinically inappropriate for me to give you clinical advice. If you want, book a virtual consultation.” We’ve come up with a platform to do a virtual consultation, and they just have a virtual consultation, and they just have a virtual consultation, we talk about stuff. And then, they usually come in for an assessment.

Shaadi: It’s worked really well, because I remember before I started any kind of social media presence, I wasn’t sure why other people were on there. I was like, “If all these people are on here and spending so much time, it must be giving them some sort of return.” So I’m actually surprised that I’ve had a lot of patients come from TikTok, actually, when the veneers crows video went super viral. I had a lot of patients off the back of that.

Shaadi: I had one patient come in. He was like, “Look, you sound like you know what you’re talking about. When I have crowns and veneers, can I come and see you?” And, he’s having Invisalign with me now. He’s a very good patient of mine. So, it does work, if you spend enough time on it.

Payman: Yeah, yeah. Look, let’s go through. You basically started your podcast, your Instagram and your TikTok on the same day kind of thing, right?

Shaadi: Pretty much. Yeah. Within a month or two.

Payman: So, I know how long it takes for a podcast to grow. Yours is consumer facing. But, I’d say from lockdown until now, it’s not really long enough to make it big enough for patients.

Shaadi: Yeah.

Payman: How many followers have you got on Instagram?

Shaadi: I think it’s nine something, 9.3K or something around that.

Payman: Yeah. And on TikTok, how man-

Shaadi: 112. It’s 112,000, I think. Thereabouts.

Payman: 112,000.

Shaadi: You’re writing these down?

Payman: No, what’s amazing is last time I looked at your TikTok, it was 101,000 or something. That was like a week ago.

Shaadi: It grows a lot.

Payman: Yeah.

Shaadi: Yeah. It grows a lot.

Payman: That just goes to show-

Shaadi: It grows quickly.

Payman: The difference in the reach of the platform. Doesn’t it?

Shaadi: Yeah. Exactly. Exactly.

Payman: Do you feel more comfortable on TikTok than on Instagram?

Shaadi: I think they’re very different platforms. It depends on what I’m doing, to be honest. Because, Instagram is very planned, very polished, very, you know?

Payman: Yeah.

Shaadi: Just planned, generally. But, TikTok is more spontaneous. It’s a question if I have five minutes between patients, I’ll film a TikTok video. I used to, when I was in lockdown, I had days dedicated to TikTok filming. I think, to be honest, I think that kept me going. Because, it was an excuse to dress up, shower, wash my hair, put makeup on, that kind of thing.

Shaadi: Whereas now, because obviously I have less time to dedicate to it, it’s just whenever there is time. But I really enjoy it. I really enjoy making videos.

Payman: To you it may seem spontaneous. But, for me, TikTok seems like you’ve got a plan. You’ve got to plan ahead, right?. You’ve got to plan where you’re pointing, and you’ve got to plan all sorts of-

Shaadi: Yeah.

Payman: TikTok seems more of a headache to post on than Instagram. Maybe my Instagram posts aren’t-

Shaadi: It depends.

Payman: As produced as they should be.

Shaadi: I think it depends.

Payman: I find it quite a hard platform. I find it hard to produce something on, even as a [crosstalk 00:31:31]-

Shaadi: It’s difficult. Yeah. It’s really difficult. I think you have to spend enough time consuming the platform to learn what works, what doesn’t work, the trends. I think it’s important to jump on the trends, and that kind of thing. But, do you know what? I found that I was spending two or three hours a day on that anyway. So I was like, “I might as well be creating.” Because, if you see enough TikTok videos, you’ll want to create one. If you see the same trends, you’ll think about your take on the trend. So yeah, I’m definitely [crosstalk 00:31:58]-

Payman: I know this is a million dollar question, but what would you say makes a video go viral? Yeah, I’m asking you for the answer. But, what would you say from what you’re learning? Some sort of juicy-

Shaadi: I will say-

Payman: Juicy title seems to work well, right?

Shaadi: Juicy title works very well. Do you know what? I think even, I don’t think anyone fully understands how the platform works. So, one video could go super viral, but another similar video could not. So, I think a lot of it is down to luck, and it’s about producing enough content consistently for one of them to inevitably go viral. But, with me, to be honest, the first video that I thought had gone viral was 80,000 views. And then the ultimate was the eight million views with the crowns and veneers one. But, I think you need to be divulging some sort of juicy information.

Shaadi: You need to grab people’s attention. And, it’s about … With TikTok, it’s about retention of the viewer. So, it’s about how long they spent viewing that video. How many times did they watch it? Whether they sent it to other people. How many people like it, comment it, that kind of stuff plays a big part in how viral that video goes. So, for example, that veneers and crown video, it was viewed for, and TikTok will give you analytics.

Shaadi: It will tell you how long they’ve spent, people have spent watching that video. A lot of people shared it with each other. They’d sent it. That’s how it went super viral. It was on every kind of LADbible, all these kind of external places as well.

Payman: You were on the news, weren’t you?

Shaadi: Yeah. I was on Russia TV as well. I don’t know how. I was actually really scared.

Payman: For people who don’t know, just go through what happened with that, because that was like a Katie Price Turkey video thing, wasn’t it?

Shaadi: Yeah, so on TikTok, there is one of the trends, so on TikTok, for people who aren’t familiar with the platform, a lot of content is for entertainment, and a lot of content is for hacks and DIY kind of stuff. So, cutting hair, recipes, that kind of thing. A trend, with regards to teeth and health was that people were going to Turkey, shaving their teeth down and saying, “These are veneers,” and then showing their before and afters and their shark teeth.

Shaadi: And, this wasn’t anything new. It was on Instagram for a while before it went on TikTok. And, I had seen a lot of people comment on this, a lot of dentists were rightly speaking up about it saying, “Look, these are not veneers. These are crowns.” But, I was kind of very apprehensive about talking about it, because I didn’t want it to sound like I was saying dentists in certain countries were bad. I didn’t want to sound like I was promoting align, bleach and bond kind of protocols.

Shaadi: So I was quite apprehensive about it. Then, I came across this video. And on TikTok, a lot of my followers would tag me in videos that are about teeth to get my opinion on it. And, if a video goes viral and everyone sees it, then more people are tagging you in that video. I came across this video of a girl who was very young, and she actually had beautiful perfect teeth. They were aligned. They were very, very white and they didn’t have any major issues. She had gotten one of them shaved down, I think at least five to five, and had crowns on all of them saying, “Look at my veneers.”

Shaadi: And a lot of people were commenting saying, “Oh, they look great. Where did you get this done?” And it was really, really scary to see young people looking up to these “influencers” and wanting to do the same things. So I made a video saying, “Look, these are not veneers. These are crowns. And these are the risks. You can get nerve damage. You’re going to need root canal treatment. You’re going to need to replace these.” And I think what you were saying about juicy content.

Shaadi: I said, “You might end up needing dentures by the age of 40,” and I think that’s what it took to make people realise that actually-”

Payman: Freak people out.

Shaadi: Yeah. That actually this isn’t like just getting false things. It’s actually a big deal. And I got loads of messages of people, like loads and loads, like hundreds of messages from people on Instagram saying, “I had no idea. I’ve been thinking of doing this. Thank you for sharing this. I was literally minutes away from booking my flight to go to Turkey to get this done.” And there was one message from, I think it was over Christmas, there was one message from this girl who was actually in Turkey and she said, “Look, I’ve come here with my boyfriend to get our teeth done, and they’ve just told him he needs four root canals before he gets his crowns done. I’m really panicking. I’m really scared. What should I do? Our treatment is tomorrow.”

Shaadi: I was like, “Look, there’s literally nothing I can do for you now. You’re in Turkey. You’re already there. This is the kind of stuff you should be thinking about before you go over there to get your teeth done. And the maintenance. Who’s going to pay for the maintenance? Do you realise these may need to be replaced?” And so it went viral. It was shared on every platform that I can think of. It was one of the trending news articles on Apple News. My dad actually was going through Apple News and he was like, “Look, this is where you are.”

Shaadi: My brother came home and he was like, “Look, you’re on LADbible.” So it was my five minutes of fame, but I’m glad it got the attention that it needed, because it made people realise that these aren’t just stuff you get done and just forget about it.

Payman: Look, that was a trending thing that you jumped on and made your own video about, right?

Shaadi: I don’t think it was a trending thing. It was just a video. It was a trend of people showing their teeth, and my video was just saying, “Look, don’t do this.” It was an anti-trend, if anything.

Payman: Got it.

Shaadi: So yeah, that’s I was surprised when it went viral, because it wasn’t anything like everybody else was doing. And then once I made my video, then everyone else, all the other dentists started talking about it as well. So, that was good to kind of echo the message and get it out there.

Payman: I’m still trying to get to the bottom of why is it you’re so confident talking into a camera. And we had you filming it in lighting.

Shaadi: Yeah, that was so much fun.

Payman: You were like a total natural. Most people sweat a bit.

Shaadi: I do a bit. If I listen back [crosstalk] to it now, I stutter at some points.

Payman: No, no, no. Believe me, you were one of the better ones. Where does that confidence come from?

Shaadi: Do you know what? I think I’ve put myself out there a lot. I’m not naturally super confident. I have my own reservations. But, I think once you start doing stuff, and you get used to it, and you realise that it’s actually working, that gives you confidence. So, with the social media platforms, the way it all started was, you know when I was at my toxic dead end job, I think I was doing a hygiene and I was like, “Look, this clearly isn’t the answer.

Shaadi: Working six days a week, 12 hours a day. So I’m going to take some time off. I’m going to spend some time working on some sort of creating some sort of a brand. Get my name out there. Then I’ll go from there.” I’m really proud of myself for that. Because, I chose to not work six days a week. I think that takes guts to say, “Actually, I don’t want to do this. I’m going to go do something else instead.” And then the results [crosstalk 00:38:43]-

Payman: Yeah, because first time we met, you were working two days a week or something.

Shaadi: Yeah. Yeah.

Payman: This was post the six days nightmare.

Shaadi: Yeah. Do you know what? And I hear, actually, when I was at that job, I heard Manrina Rhode talk about how she’s more productive working three days a week than if she was working full-time. I was like, “I couldn’t agree with you more.” Because, those two days that I go in, I’m 110% in. I’m excited. I work as much as I can. I do exciting stuff. I want to try new things clinically. Whereas, when I was working six days a week, I was exhausted. I didn’t want to do anything. I just wanted to just do a check-up, get it over and done with and just go have a coffee.

Shaadi: I think with those two days, I’m far more productive than I was at six days a week, and I have enough time to spend on everything else, like the podcast. And I enjoy it. I think it’s important to enjoy what you do. If I do clinical dentistry six days a week, I’ll be miserable, and I can’t do anything else.

Payman: Do you do all the work for the podcast yourself? All the editing, everything?

Shaadi: Yes. Yeah. Everything. That was scary. I had no idea. I had no idea how to do stuff, but I learned that-

Payman: It’s a wonderful time, isn’t it? You can Google, “How do I start a podcast?”

Shaadi: Yeah.

Payman: I often, when I think about we’re trying different things that enlighten, right? Sometimes I’m thinking, “How the hell are we going to do that?” And then every time I think that, I think this is the time where you’ve got more information at your fingertips.

Shaadi: Yeah.

Payman: Than ever before in history.

Shaadi: Yeah.

Payman: And, it’s amazing how much you can get it done by Googling.

Shaadi: It’s true. Do you know that with the whole social media platform.

Payman: Go ahead. Yeah.

Shaadi: Sorry to interrupt you. But, with the whole social media platform, I actually looked into getting a company to do all the social media platform for me. Because, I was like, “I want it to be done properly. I don’t want to just be an amateur to do it.” But actually, I’m a bit of a control freak. So I was like, “I don’t think anyone can do what I want to do as well as me,” so I’m the only one that can put my vision 100% out there. So, with all the research and Googling, that kind of stuff, I was able to do all of that. But I think it’s important, because I don’t think I would have been happy with anyone else doing it. I think I need to be doing it.

Payman: Well, then my advice is, though, on things like a podcast, you can outsource a lot of this stuff.

Shaadi: Yeah.

Payman: Okay, maybe you want to edit your own podcast.

Shaadi: Yeah.

Payman: We started out with a proper full on editor, and now it Prav’s team handles the whole thing. But what I’m saying is, you’re going to get busier and busier.

Shaadi: Yeah. Of course. I’m dedicated.

Payman: You’re not working two days now, are you? How many days are you working now?

Shaadi: I’m working four days now, but I’m going back to two days, because I can’t do more than two days.

Payman: Are you? Okay. Fair enough. But, the TikTok must take time.

Shaadi: Yeah.

Payman: I was going through it last night. What do you do? One a day?

Shaadi: I used to do one to three a day. I think that’s the optimum-

Payman: Three a day!

Shaadi: that they say. One to three a day. Yeah. But you have to be relevant. You have to be out there. That’s the thing with social media. I think you have to be consistent.

Payman: Got it. You.

Shaadi: You’re going to have off days, but you still have to have content pre-planned. But, all of this is pre-planned. So, I film and do all of that. So, if I have a filming day, then I will film as many videos as I can that day, and plan it. But it takes a lot of time, especially if you want to do well.

Shaadi: If you just want to create videos for the sake of it, then that’s another thing. But if you actually want to spend time editing them, planning them, filming them, the nit does take time.

Payman: How many can you produce in a day if you like put a whole day towards.

Shaadi: Yeah. So, if I have a day where I’m not at the clinic. I’m at home. Then, yeah, I would have planned them from before. Whenever I get an idea, I jot it down. And then, for that day I know how many films. So, for example, for that video that went viral, I think I created like 25 or something videos in that day, and that just happened to be one of the videos.

Payman: [crosstalk 00:42:27]. Really?

Shaadi: Yeah.

Payman: I like that.

Shaadi: But you get good at stuff. And a lot of it isn’t just me pointing to stuff. It’s reacting to stuff. Thankfully on TikTok, there’s a lot of videos that you can react to, and just talk about what’s happening. And people seem to like those as well.

Payman: We ask everyone this question. What do you think’s been your biggest mistakes in dentistry?

Shaadi: I think we were speaking about this before. I think, and of course I’ve made clinical mistakes, but I don’t think I’ve made any major ones yet to learn that much from. I think the biggest mistake I made was to chase down that job.

Shaadi: So I think it’s taught me when to stop chasing stuff. You have to be persistent if you want to get things done. But at the same time, if stuff isn’t happening organically, then there’s a reason. So, leave it well alone. I think that’s the greatest lesson that I’ve learned. A mistake from taking a job that I shouldn’t have.

Payman: That job got you pretty bad.

Shaadi: It did. It did. But, it’s at the forefront. It’s just there all the time. Every decision I make, every commitment I commit to, it’s just there. So it’s taught me a lot. And at the time, if you speak to my friends and family, it wasn’t a nice time to be around me. I was crying and shouting the whole time.

Payman: Wow.

Shaadi: It just wasn’t a nice time to be around me. Yeah. I wasn’t this bubbly, happy social media person then. I was just this person crying in a corner.

Payman: What about the dark side of social. Have you had any trolls?

Shaadi: Yes.

Payman: We had Rhona on this show.

Shaadi: Yeah.

Payman: And she was talking about that.

Shaadi: Yeah.

Payman: Although I think she’s quite polarising compared to you. But, tell me about the dark-

Shaadi: Well, she’s obviously much bigger, and she’s had a long time to develop her platform and her followers as well as the trolls. But, I think, yeah, quite early on, especially with TikTok, because it’s not like any other platform. One video can have massive reach. So pretty early on, you can get loads of people viewing you and your content.

Shaadi: So, there’s going to be accounts. No one checks these accounts. There’s no social media police. Anyone can come and say anything. And, I would say, touch wood, I haven’t had anything majorly negative. But there’s been a lot of negativity and neutral stuff. Like posting educational videos and then someone coming and saying, “Who cares?” Or commenting just unnecessary stuff.

Shaadi: This used to really, really bother me at the beginning. Because, like a lot of other people, I care about what other people think of me. But I think since I started my social media platform, I realise pretty early on that actually if I’m going to be a sensitive person, I should just not be on social media. Because, everyone’s going to have a an opinion. Not everyone’s going to like you.

Shaadi: I had even a dentist send something, a reply to a story I posted, thinking they were sending it to someone else, saying something negative. That really bothered me initially. But then I was like, “Who cares? Like if this person doesn’t like you, who cares?” It’s not real life. It’s just social media. Not everyone’s going to like you. I don’t really care about being liked anymore. I have a very clear vision, and I know exactly what I want to do.

Shaadi: Not everyone has to understand that. It’s okay. And as long as, especially with the video that went viral, obviously a lot of people … Or not a lot of people, actually. Like a few people, like two or three people messaged me saying, “You shouldn’t have used that girl’s video to show,” and saying that a lot of people have gone on to her bully her and things like that.

Shaadi: I made an announcement to say, “Look, this isn’t to throw shade at anyone, especially not this person. People can do whatever they want to their teeth. This is purely and educational video to say the risks. You can do whatever you want with your teeth, and please don’t misunderstand it.”

Shaadi: But then I very soon realised that actually when eight million people have watched your video, if three people say something negative, that’s okay. Ratio wise, that’s really okay. So, I very soon, very early on I learnt to get over it. That’s how I approach it now. Whatever negativity comes my way, I just delete. Delete and unfollow. That’s the kind of stuff I do.

Payman: Yeah. That’s totally the right way to look at it if you’re going to put yourself out there. But I think talking to Rhona, she had more sort of problematic ones than that. You know? Like people-

Shaadi: Yeah.

Payman: Directly attacking her.

Shaadi: Yeah.

Payman: And it can happen. It can happen. I can understand how it can happen. But you’re right. There’s no way you could have done what you’ve done if you really cared what people thought about you. I find that’s probably one of the biggest barriers to people even starting a podcast or anything like this is, “What’s my aunty going to think?”

Shaadi: Yeah. Because you know what? Who cares? The important thing is that you like what you’re doing. It doesn’t matter what other people are doing. When I started the podcast, for example, my mom didn’t quite get it. She was like, “What’s the point? Why are you making a podcast? Why aren’t you doing more clinical days?”

Shaadi: I was like, “Look. There’s a plan. There’s a vision.” She’s like, “Okay,” cheering me. I think a lot of people just don’t get it, and that’s okay. They don’t have to get it. You have to get it. And, I’ve been able to do some wonderful things because of the social media platform, like being here today. I think as long as the stuff that you’re getting out of it is outweighing all the negativity, then it’s paying off.

Payman: If there is a plan then, go on, give us the plan. What’s the plan? Is it a secret plan?

Shaadi: Life plan?

Payman: Well, you’re saying this is a planned thing. Doing your podcast, doing your social media. What’s the plan?

Shaadi: The plan is to create a brand, so that people know you for what you are and what your vision is. And then, it’s …

Payman: [crosstalk] your brand?

Shaadi: Yeah. And then just to go on and … I really want to have my own clinic, and I have a vision for it. I want it to look a certain way and be a certain kind of vibe.

Payman: [crosstalk]

Shaadi: Yeah. Of course. I’ve planned all of it. I have a Pinterest board dedicated to it. I just don’t know when that’s going to happen. But, that’s my plan. To create a brand, and then just to have my own clinic and be able to do the stuff I want to do and still be able to dedicate some time to this content creation, because I really, really enjoy it.

Payman: Okay, well do you want to expand on more of this clinic, or is that a secret?

Shaadi: I don’t know enough about it yet. I just have a board plan. I don’t want to plan too much, because then I get too excited, and I get disappointed if it gets delayed or anything like that. But there’s no solid plans as of yet. It’s just a work in progress.

Payman: I think, look, with you, I thought, the first time I met you I thought super confident, super ambitious, super ambitious, yeah? What’s that about? Where did that come from?

Shaadi: That came from my mom. 100% my mom.

Payman: Really?

Shaadi: Yeah. She’s a super woman. And, she’s just given us this idea of anything is possible, and just work hard. My mom works super, super hard. And she was the kind of person that she would go to work, she’ll come home, it will be like midnight and she’ll sit with me and my brother and write our personal statements. Like, to that extent.

Shaadi: So, I’ve just got that vision from my mom.

Payman: What does she do?

Shaadi: My mom is a technical manager for a Swiss auditing company. She’s completely non-dental/medical. But she’s very sciencey. She did engineering at Imperial, so she’s very sciencey. Every time I had problems, I would go to her. A lot of people asked me if I had tuition and that kind of thing, and I’d just, I would run to my mom and my brother if I had problems, so I was very lucky. But, the vision and the ambition is 100% my mom. She’s a very tough love kind of person. So, if she tells me I’m doing well, then I know I’m doing well. So, that keeps me going.

Payman: Yeah. You need someone like that. You know?

Shaadi: Yeah.

Payman: Because, it’s all well and good to be all cotton wool. But, you can’t measure cotton wool very well.

Shaadi: Yeah. Yeah.

Payman: What about your dad? What’s your dad like?

Shaadi: My dad is very, is the complete opposite of my mom. He’s very calm. He’s very cool. He’s very content and very zen. But I think you need that balance. Because, depending on what mood I’m in … So if I want to do something super ambitious, I’ll go to my mom, and she’ll tell me it’s possible. But if I don’t want to do something, I’ll go to my dad and he’ll say, “It’s okay. Just relax. Be happy with what you have.”

Payman: So you know how to get the right response.

Shaadi: Yeah. Exactly. Yeah.

Payman: What do you reckon is going to happen in the next couple of years for you, as far as TikTok, and your podcast? What about your immediate term plans?

Shaadi: I hope it continues to get bigger and better and lead on to more things. But, even if it doesn’t, I think it’s already done what I’ve wanted it to do, so I try not to get too bogged down in it and not be too hard on myself, because I think it’s really easy to say, “Well, if I’ve done 100,000 photos in the last year, by this time next year, I need to be on a million follows.”

Shaadi: So I think it’s important to not be too hard on yourself and not get too bogged down in numbers, and vanity metrics and that kind of thing. But I want it to get bigger, have more reach, lead to more things. And then hopefully, eventually it can help me achieve the plan and the goal of building that clinic.

Shaadi: I don’t know if it’s in the next five years, 10 years? I don’t know how long it’s going to take, but that’s the vision for the near future.

Payman: On that note, do you know when I said to you, “Do you get any trolls?” I noticed when you do that thing, “Ask me anything” type questions, you get the “Will you marry me?” All the time.

Shaadi: Yeah.

Payman: Do you get that kind of pervy troll?

Shaadi: I do.

Payman: Does that happen?

Shaadi: Yeah, I do. But, so far it’s all been entertaining.

Payman: Has it?

Shaadi: A lot of people ask me if my patients have asked me those questions, and I’ve had a few patients kind of ask me those kind of questions. But, I think I’ve learnt how to navigate them now. I kind of laugh at them and move on.

Payman: You know this question of women in dentistry, and the positives and the negatives of being a woman. And, all right, if you want to really get to you’re young, you’re a woman, you’re a minority, if you want to call it that. Do you feel those things, or do you feel like you’re disadvantaged?

Shaadi: If anything, I think it’s an advantage more than a disadvantage. Because, I think I’m able to use that, me being a woman, being young to kind of say actually I’m this kind of “soft” kind of person, but actually I can do some pretty hardcore stuff when it comes to dentistry.

Shaadi: But I think I haven’t had any problems with patients trusting me or anything like that. So if anything, I think it’s a positive thing. I just had one patient, when I was doing my VT, my VT trainer was this Asian guy. He was quite big. And, I needed to do an extraction. I called him in for an opinion.

Shaadi: He said, “Yeah, the tooth needs to be extracted,” and he left. Then, I told the patient. I was like, “Great. We’re going to extract your tooth now.” And he said, “You’re going to do it?” And I said, “Yeah, what’s wrong with that?” And he said, “I want him to do it. I don’t want a skinny little girl to do it.” I was like, “Don’t worry. It’s just technique.” Luckily, I was able to remove that tooth. If not, I would have never lived it down.

Payman: Were you like …

Shaadi: Yeah. But I was like, if anything, I’m going to take that as a compliment that you can be this kind of person and then still be able to do stuff like clinical stuff, clinical dentistry, that kind of thing. So I don’t see it as a negative.

Payman: But do you recognise what people sometimes say about not enough role models and not enough women on the podium. Not enough women in powerful positions in dentistry. Does that bother you at all?

Shaadi: Not really, to be honest. I don’t think about it. The only thing that I’ve noticed is that this one time I had a male nurse, and every single patient that walked in would turn to him and speak to him and think I’m a nurse. That’s happened again and again. That’s the only thing that kind of bothers me and kind of annoys me a little bit.

Shaadi: Or, if you see movies, and the dentist is always the male and the nurses are female. Those are the things that bother me. But, no, I think we’re doing okay. I think there’s a lot of female dentists out there, and I think a lot of us are vocal and put ourselves out there. I don’t think that’s a problem.

Payman: It’s interesting. Because, you do hear this thing that I’m saying. People say it.

Shaadi: Yeah. I can hear it coming from …

Payman: Yeah. Like people tell me I should have more women on the stage lecturing, for instance.

Shaadi: Yeah.

Payman: And that sort of thing.

Shaadi: Yeah, in that world of dentistry. Yes. In that world of dentistry, yeah, there can be more of us.

Payman: But this idea that as a woman you can’t get inspired because there aren’t enough women out there. That doesn’t seem to have bothered you.

Shaadi: I’ve got my own inspiration. I’m fine. But I can see what people mean.

Payman: But the thing is, it depends on where you want inspiration from. You know?

Shaadi: Yeah.

Payman: Because, if your inspiration is a lecture, then I guess they’re right for now. I’m sure that’ll change very quickly. But, let’s talk about if your inspiration was social media. There’s so many women dominating in social media, right? And the U.S. as well, right?

Shaadi: Yeah, and I think that’s where a lot of people are now getting their inspiration from. Whether that’s aspiring dentists, young dentists, I think a lot of people, that’s where they get most of their inspiration from now anyway. But I understand where that’s coming from. I agree in the academic world of dentistry there can be more females.

Payman: What about clinically? Do you think you’ve got to carry on with this sort of ortho, align, bleach, bond or do you want to take it in another direction? It’s very early on in your career to stick to one thing.

Shaadi: I think about whether I should have actually done ortho regularly. I think I’d say I think about it every week. But, I’m happy with what I’m doing now. I’m happy with what I’m doing now, and I think I enjoy that ortho aspect of it. But, I actually went for my vaccination in through Northwick Park Hospital last week, and it was that really sad dog-

Payman: Horrible hospital.

Shaadi: Yeah. It’s horrible. I’ve never been there.

Payman: A horrible hospital.

Shaadi: Yes. It just reminded me of everything that I hate about hospitals, and even dental hospitals. I really don’t like them. I don’t like that hierarchy. I’m sorry to say it, but I think dental hospitals have that hierarchy. It doesn’t matter who you are. Even if you’re a consultant, they’ll say you’re a junior consultant. I really didn’t enjoy that aspect of it.

Shaadi: So, I think in practise I’m really happy that I make the decisions at the clinic like in my own room, and caring for my own patients, and not having to go through that hierarchy. So, although I think about also whether I should have done it, I’m so glad that I’m not in hospital right now doing that kind of training. I don’t miss it at all.

Payman: Well, look. Prav’s not here to ask his final question. But, I’m going to try it for him. And, he never likes this question being asked when it’s a young guest. But, just don’t worry about-

Shaadi: Is this the one about dying?

Payman: Yeah, don’t worry about the deathbed element of it. Although, for me, you could get run over by a bus tomorrow, right? It’s not like death is-

Shaadi: Great thing to look forward to. Thanks, Payman.

Payman: You could. You could. That’s just the way it is.

Shaadi: You could. That’s true. It’s true. Especially now with all this negativity going around.

Payman: Exactly. So, you’re on your deathbed. You’ve got your family around you, your loved ones around you. What are three pieces of advice you’d leave them with?

Shaadi: I would say the first one, this is going to sound pretty cheesy and cliché, but there’s a reason behind it. I’d say, “Don’t worry.” Because, regardless of whether you worry or not, bad things will happy. And the fact that you worry just means that you’ve wasted all that time worrying. Because, what I learnt with that job was that it didn’t matter that I worried beforehand.

Shaadi: I was in a bad situation, and I just had to have dealt with it. Worrying didn’t help me at all. I would say don’t worry about things. And secondly, I’ll say if something doesn’t happen, don’t stress too much about it, and move on. I’ll say again, if something doesn’t happen organically, just leave it. Because, there is a reason that’s not happening. Even if it does happen, it’s going to end up being something that you didn’t think, and it’s going to be something negative usually, and it could be because something better is waiting for you.

Payman: Hold on. Hold on. Hold on. Do you mean that in a sort of, there’s a reason it’s not happening, as in like a life, everything happens for a reason idea?

Shaadi: Yeah. Because, I think usually I think I believe in fate. I believe in hard work, but if something isn’t happening, despite you trying again and again, there’s a reason why it’s not happening. Just trust it and don’t force it too much. The third thing is not to put conditions on your happiness. I think a lot of us are guilty of saying, “I’ll be happy when I graduate, when I get this job, when I make this much money, when I have this relationship.”

Shaadi: I think it’s important to have goals, but at the same time you should be happy with what you have. Because, if you put conditions on your happiness, you’re never going to be happy. Because, you’re just going to end up changing that goal post. You’re going to change the conditions of your happiness. And so, you’re going to waste all that time not being happy.

Payman: A goody, that one. That’s a goody. That sort of enjoy the journey kind of angle.

Shaadi: Yeah. Yeah.

Payman: I like that.

Shaadi: And you can still have goals. You don’t have to not have goals. But, just enjoy the process a bit as well. It sounds airy-fairy, but it’s really true.

Payman: I think some people make the mistake. It’s almost like I have to be unhappy with what I have in order to progress forward and get something that I don’t have. I think what you said there is actually, it says no you don’t. You can have skills-

Shaadi: Yeah. Exactly.

Payman: And you can be happy at the same time. You know?

Shaadi: Yeah. And I used to be like that. I used to be like that. I used to put conditions, but then you kind of learn that actually if you’re just going to keep changing that condition, that’s irrelevant.

Payman: And perhaps final, final question, generally, I show would you like to be remembered as a legacy?

Shaadi: That’s a big question. I think I’d like to be remembered as a person who cared and made people feel good and happy at a time where they needed to be looked after. I think with the TikTok and stuff, it’s all fun and games, but actually a lot of people were saying, “Do you know what? This has actually cheered me up. Because, there’s a lot of negativity, and this has actually cheered me up.”

Shaadi: So, to be remembered for being kind and making people feel good at a time where they needed to feel good.

Payman: Prav has introduced one final, final, final question.

Shaadi: He did?

Payman: It’s another dying one. Yeah? He’s introduced it in 2021. It’s like you’ve got a month to live. What would you do with the month?

Shaadi: I’m going to take all of my family and my loved ones and just go travelling around the world.

Payman: And where-

Shaadi: Go to every single place.

Payman: Any particular destination that-

Shaadi: Somewhere hot, somewhere sunny, somewhere by a beach. I’d go and travel the whole of Greece. I’ll go to Bora Bora. I’ll go to the Maldives. I’ll go to Hawaii. I’ll go literally everywhere. Just hire a private jet and go everywhere.

Payman: Of the places you’ve been, what’s been your favourite?

Shaadi: I loved Southeast Asia. I went to-

Payman: Thailand.

Shaadi: Thailand. Thailand, Bali and Malaysia. Absolutely love Thailand. I went there for my elective, and it was the best time of my life. We went travelling for a month, and just all of those.

Payman: Amazing.

Shaadi: I couldn’t pick one. All of them.

Payman: I love that area too. I love it. I love the people. I love the food. I love everything about that area.

Shaadi: Yeah.

Payman: Absolutely right. All right, well it’s been lovely having you. What was it like being on the other side of the-

Shaadi: Thank you.

Payman: Of the microphone? Much more difficult, right?

Shaadi: It was very nerveracking. It’s really nerveracking. Because, I’m a big of a control freak. I like knowing what’s coming up. I like asking the questions. I don’t know. I don’t know. But, thank you. What’s it been like for you? Because, now you’re on the control end.

Payman: When I was on your end, when I was on your show, I found it very uncomfortable. Very uncomfortable.

Shaadi: You did very well. You did very well. You sound very comfortable.

Payman: Yeah, but it didn’t feel good. It’s much easier on this side. Much, much easier on this side.

Shaadi: Yeah, I agree. I agree. Well, I’ve done it, now. And your show is an hour. Mine is like 20 minutes, 30 minutes. Your is a whole hour.

Payman: It’s all that editing you do, there. If you just leave it alone, you’ll be an hour. Anyway, thank you so much for doing it, Shaadi.

Shaadi: My pleasure. Thank you so much for having me.

Payman: I really look forward to your future content that’s going to come I’m sure in every direction. I’m sure we’re going to see a channel on this, what’s this new one called? Clubhouse. On this Clubhouse now. Let’s see how you do-

Shaadi: I didn’t know. Is that a thing?

Payman: Yeah, yeah, yeah. Clubhouse.

Shaadi: Gosh. I need to go get on it now.

Payman: We will need to get on that. That’s the problem when you get really good at one thing, the next thing comes along.

Shaadi: Everyone expects you to keep going, isn’t it?

Payman: Me, I’m really good at two-page adverts in magazines. I’m really, really strong on those. Yeah. Life moves on. Thanks a lot for doing this, Shaadi.

Shaadi: My pleasure. Thank you so much for having me.

Payman: Take care. See you soon.

Speaker 2: This is Dental Leaders. The podcast where you get to go one-on-one with emerging leaders in dentistry. Your hosts, Payman Langroudi and Prav Solanki.

Prav: Thanks for listening, guys. If you got this far, you must have listened to the whole thing. Just a huge thank you, both from me and Pay for actually sticking through and listening to what we’ve had to say and what our guest has had to say. Because, I’m assuming you got some value out of it.

Payman: If you did get some value out of it, think about subscribing. And, if you would, share this with a friend who you think might get some value out of it too. Thank you so, so, so much for listening. Thanks.

Prav: And don’t forget our six star rating.

A phone call from out of the blue marked an unexpected entry into the world of dentistry for this week’s guest.

Dental mergers and acquisitions specialist Max Bazzucchini tells us how he became one of the profession’s most trusted valuation advisors.

He shares his thoughts on the UK market and dispenses some insider tips and wisdom for both buyers and sellers.

“If you are in the moment – in the present moment – and you work very hard, you can have it all.” – Max Bazzucchini

In This Episode

00.48 – Backstory
10.03 – Love at first sight
15.54 – An offer you can’t refuse
20.49 – A kid in a candy store
26.08 – Growing value
30.17 – The valuation process and EBITDAR
36.41 – Lending and purchasing
42.23 – The art of the deal
50.54 – The COVID effect
55.08 – On flipping
59.08 – Buying and selling mistakes
01.01.16 – Thinking of Italy
01.09.09 – Last day and legacy

About Max Bazzucchini

Max Bazzucchini gained business studies qualifications in Perugia, Italy, and completed physiotherapy studies at St Mary’s University, Twickenham.

Following the purchase and sale of a gym in Italy, Max became a certified business valuer in the dental sector. 

In 2008, he joined ADP Group as head of mergers and acquisitions, supporting the purchase of 132 practices.

Max is currently a director and partner of Pluto Partners – a specialist healthcare valuation and advisory business based in Kent.

 

 

Max: And a good deal is always on a win-win basis. You want to maximise the price on the sellers and you want to make sure that the buyers are paying the right price, which is sometimes over the asking price, more often than not it is over the asking price, but not crazily as an independent specialist and independent buyer, which you will never recover the money that you would pay. So the biggest mistake for buyers [inaudible 00:00:25].

Speaker 2: This is dental leaders. The podcast where you get to go one-on-one with emerging leaders in dentistry. Your hosts, Payman Langroudi and Prav Solanki.

Prav: Max, welcome to the Dental Leaders Podcast, we’ve had numerous conversations regarding just the marketplace of buying and selling dental practises, you’ve educated me a lot during our conversations, and I’d like you to not only share that knowledge with our community but also tell us a little bit about yourself as well. So welcome to the podcast, Max, and just kick off by telling us a little bit about your backstory; where you grew up and your upbringing.

Max: Thank you, Prav, thank you Pay, absolute pleasure talking to you on this podcast. Yes, I’m a 43 years old kid, Italian, I was born in a very small village in the centre of Italy, on the border with Tuscan and Umbria, and I was lucky enough that my family were a strong family altogether, growing up in the same house that my dad actually built. So he’s a very skillful and charming man, skillful builder.

Max: I’m the third, number three of three boys, and there’s a fairly big gap in between me and my brothers, which is justified by the fact that my dad was offered a life changing job opportunity. So he went from being a builder and earning enough on every month to have enough food and enough comfortable life, to as you know in Italy there are lots of mountains, so there is a need, a necessity for tunnels and roads. So he actually was offered a job to be with his friend, an engineer from our village, to be his assistant director. He started building roads and tunnels.

Max: Then in this gap, in between having my brothers in myself, he made enough money and then I was born. So I would say I was born in a completely different situation from my brothers and never really experienced what they had to go through before, but having said that my dad never really gave me anything for free. He made me work for absolutely everything. He gave me, provided for me for private educations and so on and so forth, a comfortable life, but he made me work for absolute everything, even holidays, first motorbike, first car. Which is great, I appreciate that because he gave me an understanding of working towards something and the value of some things.

Max: I guess when he was building roads, one of them was near to our house, the advantage of that is that I was learning to drive when I was very young. So when I did my driving test exam, I passed within two or three lessons because I was driving better than the examiner really.

Max: So I then went to university in Perugia at the age of 18, nearly 19, I left my house. I went to study sports physiotherapist, which it was kind of an evolution from playing basketball, I liked the anatomy and physiology of the human body, so I went to study that. I used to live in the centre of the city, Perugia, beautiful mediaeval town.

Max: Then I used to go to a gym near to my flat, near to my apartment, and I became a very good friend with the owner, a guy called Angelo. I went the first month, I paid the membership, the second month I paid the membership, and I remember the third month going to the gym and saying to Angelo, “I’m not going to pay you this month but I’m going to make you an offer, I want to buy half of your gym.”

Max: The reason why I said this to him is because I noticed that the gym was never really full to its potential. There was a lot of people living in the area but not many people were going there, so I spotted an opportunity. So we had it valued. I guess there was my first experience in valuation of a business, really, on a business I wanted to buy.

Prav: How old were you then?

Max: I’m 19.

Prav: Wow.

Payman Langroud…: Did you buy half of this gym at 19?

Max: I did, yes. We had it valued and it was valued 200 million liras, which in today’s money would have been just over €100,000. So I went to my dad and he lent me the money, he gave me just over €50,000, I bought half of the gym, I renamed it, I called it Magic Body, the love of English language kind of was born in there already.

Max: The first few months I did nothing because I think business grow through evolution. You don’t want to go and make changes straight away. So the first two or three months I wanted to understand completely how the business was run. Whilst I was studying, my sport physiotherapy qualification, then we started to implement changes and some of the changes were for example, I contacted my good friend Alejandro, a Cuban world class dancer, and then he started doing Latin American classes. Then my friend Dmitri in doing martial arts, my friend Lenny from Greece who was doing some modelling, she was studying international law and she went to do yoga.

Max: So the business went from we basically quadrupled the number of members when we started to implement these changes with minimum investment costs. My advice was to invest in marketing and expand the level of services. Well, we provided this service for free providing that you were a member of the gym. So we kind of quadrupled the number of members.

Max: So my dad when he gave me the money, he said, “I want the money back within four years, interest rate.” Two years and a half later we had the gym valued again and it was worth over double of what it was valued, and I got very much involved in that process of valuations of the business and that’s kind of where I started to love business valuations and growing some sort of business, and I thought this is a way to have fun and make money, rather than working every day on my sports physiotherapy. So I had to do a lot of treatments to make the same money I just made by buying and growing a business.

Max: So I got the money back, I give it to my dad, I’ve got enough money then to buy an apartment, which is still today in today’s rented out, after 14 years. I lived in the apartment for a while and then after I sold the gym I decided I’ve been working very hard… I was also going out partying because I think, I feel, you can have it all. It’s not like if you study you can’t do this. I think you can have it all. The same you can have a career and you can have a family. If you are in the moment, in present moment, and you work very hard, you can have it all. That’s my mentality anyway.

Max: So then I sold the gym, I bought myself a nice little car as well, which used to belong to a football player [inaudible 00:08:15], nearby from Forenza.

Payman Langroud…: What car was it?

Max: Oh, beautiful black fiat coupe.

Payman Langroud…: Okay, cool.

Max: Loved it, absolutely loved it. I was about 22, 21, 22. And going with this, my long hair, fiat coupe, and I paid, I remember, €10,000 for a six months old car, brand new, with a cost 24. So I thought that’s a bargain so I don’t really want to buy a brand new car.

Max: But then I decided, after that, I wanted to travel because I really loved travel and I didn’t have the opportunity to do it in the times I was in Perugia. I made a lot of friends, which was the benefit of being there, which still have lots of good friends in there but I didn’t have the chance to travel. So I wanted to work and travel so I decided then to go, which this is something that me and former Italian prime minister [inaudible] have in common, which is not the party or anything that you might think of, but we both started working on a cruise ship. It was a pianist on a cruise ship and I decided to be a spa manager.

Max: So I travelled for a year and a half, two contracts. The first contract was in Europe, south Europe, Spain, Portugal, Greece, Italy, and then we went to the north of Europe, the Nordic Sea, St Petersburg, Norway, absolutely stunning places. Then the second contract was in the Caribbean in central America, Guatemala, Honduras, so I travelled a lot and also while I was working.

Prav: So Max, what was your plan at this stage because you’d done your physiotherapy, you’d got your qualifications I’m assuming, learnt your craft. You’d bought and sold a business. Was there a master plan here or did you just think, you know what, I’m just going to take a few years out, go and travel the world and enjoy myself, earn a bit of money to keep myself alive while I’m doing this and then roll out the master plan? What was going on in your head at this time?

Max: I didn’t actually have a plan. I just wanted to… Luckily I graduated, I finished my university and I didn’t have… I was debt free, so I had enough money and I had an apartment, which when I was travelling did make some sort of income, which was not many of my friends were in my situation really in where I was. So I was quite comfortable, so I didn’t have a plan.

Max: When I went working on a cruise ship, trust me the last thing you’re thinking is about getting married. So you are 24, you go working on a cruise ship, you just want to go and enjoy life. Literally I remember I embarked in May, beginning of May, and at the end of May we were having an absolutely fantastic night in the middle of the sea having a crew party under the stars, beautiful, beautiful time, and I was sitting and drinking something with my friend the fitness instructor Johann [inaudible] from Romania.

Max: And I see this girl and I’m thinking wow, she is absolutely beautiful. I know it sounds a bit cliché but I still remember today what she was wearing and how she was walking, all of those things. So I turned around to my friend and I say, “Johann, I like this girl, you know what? I think I’m going to marry her.” He was like, “Yeah right, that’s crazy.”

Max: Then I started to get to know this girl, she was a dancer on the ship, and we started to get together a bit more, then we went together on my second contract in the Caribbean. I then decided actually, I do want to marry her because as crazy as it sounds I think she’s the love of my life, I think I found her. Slowly she got there as well, I got there straight away, she eventually got there as well. I wanted to buy a ring and I had a ring made in someone Puerto Rico but a ring maker in the back of his garage, platinum ring. I bought the diamond in Key West, I had the diamond made, I had the right made, and then in Antigua we were in sandals on a day that we were having a day in Antigua from the ship. We went in the sea, I had my ring, and I proposed to her and she said yes.

Max: So after that we came back to Europe and back then we didn’t have the mobile phone or anything, communications with family was quite scarce. So we get to Tenerife after crossing the Atlantic and we are in a queue waiting to make a call back to family. So I said to her, “You go first.” And she called her parents, mum and dad, and I called mine after. I said, “We’re coming back. By the way, we’re getting married.” They said, “Who are you getting married to?”

Max: So my parents, [inaudible] now I’ve got kids, I think is absolutely crazy, but my parents were like, “Well if you’re sure, if you love her, go for it.” And it’s the same, my parents-in-law, they did the same thing and we’re still married together, we’ve got a beautiful family, two kids, 15 years later. So I’m a bit like that. If I think something is right, I go for it.

Payman Langroud…: This is how you ended up in England because she used to be-

Max: This is how we ended up in England. We got married in England in a beautiful village in the south of England in Kent, and then we had also a small party in Italy, about 400 people turn up as you do, probably you do the same with Indian weddings. And we’d been in Italy for a while, for about a year. My wife at the time was a professional dancer and she was predominantly working in England and most of our work was in England in the West End. She did one contract in Rome but even for that contract she had to go and audition in London [inaudible 00:14:34].

Max: She was spending most of the time in England, and in that year I spend a lot of time doing business studies, the equivalent of an ECCA valuation courses and learning valuations and the methodology of the valuations of businesses. So I decided I don’t really want to spend time apart. If you are together you want to be physically together. So we decided okay, let’s go to England, let’s give it a go, and see how it is.

Max: So I then rented out my apartment, and I went from like many Italians moving to England, moved to London, and I went from… the first few days it was quite hard, it was quite challenging. There wasn’t one hard thing, it was kind of a combination of several factors, but obviously I had my focus that no matter what I wanted to make a success of staying in England and most of all I wanted to make a success of my relationship and build a family. So this was my, at the plan, my main plan. I want to have a family, I want to be with my wife, and something good will come out of this, and eventually it did. So we moved to Putney, I believe not far from where you are Payman, beautiful place.

Prav: So Max, I’ll kick you off. From there your plan was you move to the UK and your number one plan was you wanted to make a go of your relationship. What about your career plan, Max? Did you have an idea, you talked about you started doing these qualifications about valuing businesses, et cetera, et cetera, right? What was the career plan at that point and then fast forwarding, how did you get into dentistry or was there a transition? Did you do something else before you went into dentistry?

Max: Yes, I did, and I did it whilst I was studying English. So the first thing I wanted to do was improve my English, which was not very good at the time, so I went to study English whilst I was applying for several jobs and I wanted to work for, still in the business of buying and selling valuations, so apply for working with some private equity. My English wasn’t great, so that’s what… it kind of was my weakness at the time.

Max: So I needed to focus on improving my English, which I did, and the work I was doing at the time, I was working as a medical sales rep for a pharmaceutical company. You had the basic salary, and it was a limited commission level, so I really went for it. I was making good money, consistently one of the top three in the country for my company, a company called Nutricia, part of the Danone group. I did it again whilst I was studying English, which I studied in [inaudible 00:17:32], I was going there in a college and then working for this company, very early, meeting GPs and going to work in hospitals and then studying during the day and working in the evenings. So long day, long hours, but that’s what you’ve got to do when you’ve got a couple of things to do at the same time, really.

Payman Langroud…: Max, what was the first time when you got into something to do with dental? What was the first time you saw something to do with dental?

Max: It was the summer of 2008 and I am in a carpark in St Georges [inaudible] Hospital, I just finished a meeting with dieticians there, closed a good contract on the stuff we were selling them, and I have a call from this guy talking to me with a very low, deep voice in American accent. He sounded a bit like Corleone from The Godfather.

Max: So I imagine, low voice, right? So we’re having this really low, deep voice conversation. This guy says, “I’m calling from a private equity called [inaudible 00:18:33], we’re just to cover a group of dental practises called ADP Dental after the Icelandic bank [inaudible] collapse in 2008. We are looking for someone who can help us to grow through acquisitions of dental practises.” At the time I didn’t even know you could buy and sell dental practises.

Max: So I went to the interview and I remember going to this office in Reigate. It was full of all of these seniors, let’s call it senior people with the suit and tie in their offices, and there was me going to the meeting with my pink trousers and my blue jacket and sunglasses on my head. They probably thought the pizza delivery guy turned up. I had this interview and I remember talking to this really call guy and he’s talking to me with so much passion about what they’re doing and their vision and what they want to do, which I bought into his passion without actually fully knowing what they wanted me to do.

Max: His name was Nick Rolph, which then became my business godfather, my mentor, my friend, and now my partner in Pluto Partners. So that was back in 2008. I spent the first-

Payman Langroud…: So what was the situation? What was the situation with ADP at that point? How many practises did they have, how many were they looking to buy?

Max: They had about 50 practises, and I spent about five, six months of my first time there learning about the business of dentistry, I didn’t know what UDAs was or anything like that, so they told me everything. I have to say I-

Payman Langroud…: What was their plan? Did they say to you, “We want to expand to 100,” or what were they saying?

Max: Yeah, they wanted to grow to at least 100, but having organic, consistent growth through positions of quality practises, not just the quantity, not just getting anything. At the time they wanted to grow through acquisitions of single sides, maybe small little groups, and not much tendering because the tendering was only providing low UDA value, which from a group perspective was not really profitable. You needed about 25, 26 UDA value in order to make it profitable.

Payman Langroud…: In that situation does it feel like you’re like a kid in a candy store in a way because these private equity, it almost feels like you’re spending other people’s money isn’t it? Was there loads of money, was money not a problem?

Max: Money was not a problem but there were very strict, prominent criteria for the type of practises that I needed to buy. So I needed to make good deals and my role was I was kind of the conduit between the practise sellers and the investors, so I was the middle man trying to do a good deal for everybody, it wasn’t about buying cheap because otherwise they wouldn’t sell to the group. But equally I could then waste someone else’s money. Even it wasn’t my money, I never really throw money away anyway so I always value that, nice to [inaudible] at the right price because you make money when you buy, you don’t make money when you sell, you have to buy, right, in order then to sell at an enhanced multiple.

Max: So then we grew to 132 practises through a combination of single size acquisitions and groups. I remember my very first deal, and as many brokers will tell you, or a positions manager or former acquisitions manager will tell you, you remember your first deal and you remember your last deal. My first deal was a group of practises in [inaudible] with a bank account in the Cayman Islands. And I’m thinking, that’s great, I’m going to go back. The lawyers say, “No, you’re not, that’s not how it works.” But I was a bit naïve anyway at the time, and that was a good deal, very good deal for everyone.

Max: As I said, I remember now my last deal as advisor as opposed to buyer, which was done just before Christmas. So going back anyway to ADP, then we then sold or shall I say our investors [inaudible] got together with Carlyle, the biggest investors owning IDH Group, to put together this super group which was the biggest dental group in Europe at the time, and that happened in February 2011. So I went through learning and understanding. Nick Rolph was more instrumental in this deal but I was kind of shadowing him and learning and understanding an exit strategy at high level.

Max: So we then work for IDH for a period of time, about a year and a half, continuing buying practises for them and grow, network owner of IDH, David Hadley, exited the company a couple of years later, and he decided to invest in another project, a consolidation of GP practises, and then he asked me to go and work for him, which I did for a couple of years. So I have some experience in another healthcare sector, which is now helping me to understand and bring something else, something different to the table in the business of dentistry.

Payman Langroud…: What happened with that business? What happened with David Hadley?

Max: So as you know, GPs don’t know they have sellable commodities because you can’t really sell a GP practise but you can do it through [inaudible] partnerships anyway. So it’s not that you are calling a dentist and they know they can sell a dental practise, which is relatively easier as opposed to a GP practise.

Max: So it deals on a one-to-one basis, we’re kind of taking a longer time than the dental deal so you’re looking at about 12 months end-to-end for a deal completion. So we decided to approach a group and we brought a group of about 45 GP practises for the morning health and at the time I’m thinking the buying and selling is what I like to do, I don’t really like the integration into the group.

Max: But me and Nick Rolph, since selling ADP, we always wanted to set up an advisory firm in advising groups and large practises on their exit plan and maximising on the value, but when he was ready I wasn’t ready and vice versa. So when I was ready he was working with Sherry Blair on a big fan project, then he went working with Dentex as a chief operating officer. Then he was ready and I was ready and then we are back in 2018 now, so we start putting together the plan to set up Pluto Partners, and one of the things I wanted to make us different I guess from anyone else out there, I wanted to have a dentist as a clinical partner and clinical advisor because we are advising dentists on how to maximise on the value and nobody better than a dentist can understand how to run and help on the exit transition. So we have a practising dentist with experience also in buying his own practises, advising us on every deal that we take on the table.

Payman Langroud…: So if someone wants to sell their practise, how long before they sell their practise should they start growing the turnover or reducing the costs, how long should that process take?

Max: I think it’s difficult to say a specific time, but the longer process it takes the better, the more timing advance you start planning the better it is. I would say if you are thinking about selling in five years’ time then start now. I think it also depend on the type of practises that you have. If you have a fully associate practise and you’re running it, you could sell tomorrow really if you are ready. There are always things that you can maximise, I don’t know, for example reducing lab costs and making sure that the income is equally spread amongst associate, perhaps, rather all on one associate, but if you are the main performer in the practise then we advise try to make yourself less indispensable, because it’s not that you can’t sell, you can still sell, but if it’s a group buying your practise, if it’s a corporate buying your practise, they’ll probably ask you to stay for a period of time to minimise the risk on the investment, and if you want to sell and exit, then you need to try to make yourself less indispensable. I would say try to plan in advance two or three years before, really.

Payman Langroud…: And how much do you think… I mean what kind of percentage change can you make… I’ve got a friend, he’s thinking of selling his practise, and it’s a nice practise, it’s a nice practise. I think it probably turns over, I don’t know, a million pounds. He says he’s not going to do any of that, he’s just going to sell his practise. What percentage change do you reckon you could make to the selling price if he spends a couple of years cutting cost and trying to push up revenue and all the little tricks that… I mean, I guess it’s not a trick, it’s just the way it is, right?

Max: Yeah, of course.

Payman Langroud…: What percentage difference could you make by focusing?

Max: Well, the key part is in making the changes in advance and not doing last minute changes. I mean for example, what we noticed recently, not just in dentistry but everywhere, is how digital technology has become a lifeline for so many over the last few months. What I see that the practises, they are implementing digital dentistry for example. They are becoming more profitable as they are instantly reducing their lab costs.

Max: Typically our clients, if they have an 8% lab cost, after their investment if they invest maybe on a [inaudible] machine for example, they can reduce their cost by 2% in the first year. On a million pound revenue practise as you mention, 2%, that’s £20,000. This can possibly affect the profit margin and instantly can improve the valuation by, if we say on average seven times multiple on EBITDAR, then it’s £150,000 added value to your business. So obviously there are certain things that you can save.

Payman Langroud…: So each pound you save is worth £7 on the sale if it’s a seven times EBITDAR obviously.

Max: Yes, every pound you save is going to be a £7 added value to your business, providing that it’s a sustainable change. If you make a change and you go below the average, so if you go around it… let’s say for example support staff cost average for practises, you’re looking about 17% right now, and if you reduce that massively because you want to sell to a 10% or an 8%, that is not going to be sustainable from a new buyer’s perspective. So obviously you have to make changes that are going to be sustainable going forward. And the lab [inaudible] cost, for example, is one of them, as well as of course improving the… reducing, for example, the [inaudible] time you can reduce or certain other improvements that you can make with implementing digital transformation.

Prav: Max, would you mind just in real simple terms summarising for us how a practise is valued, and I know there’s numerous ways of doing this, but on the whole how a practise is valued. But also, what are the deals that present themselves on the table that practise owners may or may not be aware of, and the things I’m thinking about is retention period, how long they’re required to stay on, what does that deal look like for them, what are the consequences for them if they don’t hit certain targets? What are the usual pitfalls they need to look out for when looking at a deal of how a practise is valued and on the face value they may think okay, they’re going to get X for their practise, but in reality they’re getting 60% or 40% deferred over five years, and hitting that deferral target may be more challenging than they anticipate. Would you mind just summarising those few points?

Max: Yes, so okay, let’s talk about the defer first and then we talk about how we value practises. So in terms of the defer consideration, that is the part of the deal price that is paid over a period of time, provided that certain targets are met. Different groups… Usually this is done by corporate purchases, not much from independent buyers. So certain groups will apply different types of criteria and KPI and key performance. We, as valuers and advisors, we always advise to our clients to make sure that the targets are achievable, but in reality Prav, what you get is the payment on completion; the rest, I consider it a bonus.

Max: So the higher the payment on completion the better it is, so we always try to negotiate on behalf of our clients, but equally buyers want to make sure that the risk on their investment is minimised anyway. So certain groups have the target of EBITDAR growth, which to me is difficult really, because giving a value to a business based on growth is a difficult concept for a seller, and as in EBITDAR as the target, also can potentially create some arguments. So I would say having revenue instead as the target I think is an easier black and white, much simple concept for [crosstalk] consideration.

Prav: Just explain to me very quickly, what is EBITDAR? Just in very simple terms to a practise owner. I’ve spoke to loads who don’t even know what that means, and why should they, right? If they’re not in the process of selling or buying practises.

Max: Yeah, the EBITDAR, the actual meaning of EBITDAR is an acronym which is made out from other different words and it’s the earning before interest, tax, depreciation and amortisation. In simple terms, it’s the true operating profit of the practise, after all costs, essentially. If you are a practise owner and we have an associate level valuation model, corporate level valuation model, then obviously they need to include the costs of your clinical income added back to the valuations and then you will have usually 15-18% of the profit margin on a million pound [inaudible] practise would be EBITDAR.

Max: The multiple that are applied at the moment is around seven times on average, so obviously the higher the EBITDAR level the higher would be the multiple, and we think just-

Payman Langroud…: Max, sorry to interrupt Max, how does that compare with other industries? I mean, let’s look at other professions, I don’t know, lawyers, architects and accountants, or just real companies, software companies or whatever. You’re in the valuations world. Are dentists in an over… are we in a bubble or have we got further to go as far as EBITDAR multiple?

Max: Yeah, it’s funny you mention bubble because this is a word that’s been mentioned many, many times, and the bubble never really burst. There was kind of people were expecting this to reduce, the EBITDAR multiple. Compared to other industries, the EBITDAR applied to dentistry is really high. Compare even, and we see this, we do this exercise quite a lot, compared to the same industry in other countries, it’s also very higher. In England the average is, at the moment, on transactional EBITDAR level 6.7 across all type of practises on associate led model. In Italy you’re looking about four times, in USA you’re looking at 2.5 times EBITDAR. So England is a very higher EBITDAR multiple. Pharmacies also have a much less EBITDAR, you’re looking at four, five.

Max: So dentistries are a very profitable business from… you’ve got a high multiple in dentistry in the UK. I guess it’s driven also by the NHS revenue and the fact that you’ve got guaranteed income on a monthly basis and investors really like this, and no one else in Italy, 96% of business is private and you do get high quality treatments, you also get very low quality because of the lack of regulations and standardisation, and there is no government income given to practises on a monthly basis, like in England on the NHS… I guess one of the point is that, and we’ve seen it now during the pandemic and during last year, prices really…

Max: And we did say this, me and Nick back in March and April last year, we were expecting prices not to change and in fact prices didn’t really change, the multiples remained the same. Obviously what is changing and what has changed is the multipliers. What we are multiplying might be changed but the multiple applying to the EBITDAR, that has not changed, and banks are still providing valuations based on a pre-COVID level, and that’s what we do. So to answer to your question, Prav, how we value-

Payman Langroud…: So are the banks lending?

Max: Lending is happening. There are 14; 13, 14 major banks still lending. The criteria has changed so you would need a higher amount of deposit, but the confidence in the sector is still there. The demand is there and the confidence is still there.

Payman Langroud…: So what kind of percentage are we looking at, deposit wise?

Max: You’d be looking at 20% as opposed to 5-10% pre-COVID at the moment.

Payman Langroud…: 20.

Max: I’m pretty sure. Yeah, 15-20 on an unsecure level.

Payman Langroud…: So then when you look at the market now compared to… I’m not even going to go pre-COVID, I’m going to go six months ago, what are the differences? We had Andy Ecton on from Frank Taylor, and he said there was a bunch of associates who wanted to buy their own practise now because of the nightmare of being an associate during this pandemic period. If they were thinking of buying a practise, that’s kind of accelerated them wanting to buy a practise. Have you seen that too?

Max: We did see this, yes. We experienced a 17% increase in the number of associates registering with us to want to buy their own dental practise. So we now have about just under 5000 registered buyers, probably active 25% of them. There are 750 practises coming to market on a yearly basis. Probably a little bit more now.

Max: Associate… That’s the biggest change, really, that we see during the last six months of last year. Prices have not changed, what has changed in the market is the change has affected the associates most of all in two ways, I would say. The first way is that principals are working more in their practise, therefore they’re reducing the level of income to the associate. And also, the associate, they are asked to work. Most of the time they are to accept a reduction in the pay. So their percentage went down from 40, 45, to 35 for example. So they had a reduced level of income.

Max: So that [inaudible] triggered them obviously to buy into a security of a job for the future, so buying their own dental practise. But the other thing I notice is I don’t know how you would define it because it’s something quite new, but there are new associate that instead of buying that practise, they are building and developing their own brand within the existing practise.

Payman Langroud…: Yeah. Super associate.

Max: Probably I call it [crosstalk 00:39:31].

Payman Langroud…: We call them super associates on this show.

Max: Yeah. Super associate might means they are better than other associate. I’d probably say brand associate, but yeah. So what they’re doing, they are building their own brand within an existing practise. I think it’s great in the short-term for a practise owner, in the long-term and added value to the business, I don’t know. It’s questionable. There will have to be a strong relationship and a strong contract in place. For example, if you are a practise owner and you have two or three different brand associate or as you call it super associate over the course of three years then you can justify to a buyer that you had three different type of these associates. So they can have the same. But if you have one of them, and they maybe are responsible for 40% of your income, they can leave the day after you sell your practise. So buyers are not naïve.

Max: I guess from a practise value perspective, it’s difficult to give a value to that, but in the short-term certainly can improve revenues. So that is the biggest change, really.

Payman Langroud…: Max, do you ever work on behalf of the buyer or are you always on behalf of the seller?

Max: We do. We work for the deal and we work for the good deal, and we either work on behalf of the buyer or on behalf of the seller. We never get paid from buyers and sellers, so we are very transparent in our front. When we work on behalf of a buyer, usually we worked with large groups and we advise them on several deals. A couple of years ago we actually advised one of the largest group, [inaudible 00:41:24], on the acquisitions of a group on Nottingham in south Wales, which was, at the time, the biggest deal that we brokered, and I guess the biggest deal done in 2019 with the value and the number of practises.

Max: So we advise buyers in terms of large groups as advisory firm but we predominantly work with sellers. It’s one or the other. You can’t work on behalf of both. So we either get paid from one or the other.

Payman Langroud…: But as an individual, do you ever get an individual coming to you and saying, “Look, I want to buy a practise and I want to pay you to find me the right practise.” Is that a thing?

Max: We give a lot of advice, we don’t go in searching for a practise specifically from an individual, but we advise and we educate what to look for, and we sometimes help them on a negotiation process but we don’t specifically go out and find them a practise.

Prav: Max, I want to sell my practise and I could go directly to one of the corporate acquisition department for example, deal directly with them, hire a good lawyer, and do the deal myself. Why should I pay somebody like you to take a cut of that deal if I can just keep the full slice of the cake of the deal and then-

Payman Langroud…: Is it to save the 1%… How much is it, Max? Is it 1%, 1.5%? What is it?

Max: Yeah, we charge 1.5%.

Payman Langroud…: Oh, man. The way I would think of it is he’s going to get me 2% more.

Prav: Yeah, of course. Because I’ve not finished asking my question yet.

Payman Langroud…: Sorry.

Prav: With that in mind, can you illustrate any deals where you’ve actually acted on behalf of somebody selling it and to what extent you’ve increased the sale deal.

Max: Yeah. I like to say I have a good relationship with most of the groups and the acquisitions team and the M&A guys and ladies working in the groups. When they see my involvement, they instantly become aware there’s going to be tough negotiation and it’s not always the case if you go and approach them direct. Most of the time, a practise owner will do this once in a lifetime, they will sell their practise and they will have only had one opportunity. They again offer and they maybe think this is the best and final. And maybe they don’t… they might be great clinicians but they’re not great at negotiating, they don’t know what buttons to push.

Max: Now my experience and my background obviously is buying practises so I know what buttons to push in order to increase the value, we know what can improve the valuations and the negotiation, we know what we can achieve. So sometimes we see an initial offer and it’s not just about the price but it’s also about the terms and the amount that you get on the defer basis.

Max: In terms of example, I can give you an example which is quite exceptional, really, there was a practise in Buckinghamshire who came to us with an offer on the table for 1.8 million.

Prav: They came to you and said, “I want 1.8 million for my practise.”

Max: No, they said, “We have an offer for 1.8 and I think it’s good.” And he was from one of the groups. So I analysed the figures and then of course we can talk about how we value and prices and a minute. Then I thought it’s a good offer but I think we can improve on that offer of 1.8. The way that you can improve it is by creating a nice competitive tension, not just with that group, but introduce either two or three potential buyers that you think they’re a good match, and we did so.

Max: So consequently, we started to get offers, and the same group who offer 1.8 and it was the best and final, a couple of months later they offer 2.4. So obviously it wasn’t the best and final. But then eventually the deal closed at 2.7, which I was very surprised, but I think I’m pleased with what we did there and the clients were pleased. So he ultimately ended up selling to another group, not to the same group.

Max: So your 1.5% save I would say is more than justified by involved someone like us that can introduce and bring to the table different groups, and sometimes also trying to maximise on the current offer that you might have from the same group.

Prav: So even if you’re mid-deal with a corporate or a buyer, it’s still not too late to engage a professional like yourself.

Max: No, it’s not. Obviously you need to try to find the balance in not to upset the buyer but it’s in your best interest, you need to maximise, it’s your chance, it’s your opportunity, and it’s probably once in a lifetime opportunity and it’s an exciting time to sell your business and you want to make sure that you… Especially if you ended up working with a group, there is not a sentiment in the value that you got, so you need to make sure that you get the right value before you sell, not realising it after by talking to your friends and say actually I could have sold for more or my conditions could have been better. So you have to explore all avenues and make sure you get a good deal in terms of value and in terms of terms.

Prav: What’s the right… one of the conversations I have with a lot of practise owners is well, when is the right time to sell? Can you time the market when a corporate is about to exit so you can get a higher multiple value at that point? Is there a right time to sell? Are we at a point where the EBITDAR multiple is at such a peak at the moment, now is a good time to be having these conversations, and if we left it a few years that may drop? Is there any insight you can give us on that?

Max: The right time is always when it’s right for you as a seller. And it’s always about approaching a buyer at the right stage of the cycle. You will have groups, if you’re talking about corporates right now, you will have groups that we go through different cycles in their acquisition strategy. So at the beginning of their acquisition strategy after the initial investment, they want to go in a very aggressive way, so their multiple there might be quite competitive compared to other groups.

Max: Equally, towards the end of the cycle when they have an offer from a private equity or a different groups or a bigger group perhaps, then they will be thinking if they buy a practise or they buy 100 grand of EBITDAR at seven times, for example, immediately this will add 10 times value to their existing group.

Max: So the end of the cycle and the beginning of the cycle for a group is always when you want to approach them. Sometimes, like we did in one of our biggest deal, is also for groups they are potentially kind of a midlife in the cycle, but they are behind on their acquisition strategy, so they really want to push up their acquisitions by making one group purchase or buying several practises and just boost the pipeline and it’s just about always being in touch with groups and understanding where they are at the moment, so there’s no point approaching someone for example now, like Bupa for example they exited the market.

Max: And I have to say, nobody never ever exit the market. If the right opportunity comes to the table they might consider it but they’re not actively as they were two years ago or a year and a half ago. So you always have to try to approach everyone with a specific emphasis on who is more active and where they are in their cycle.

Prav: Do you have insight into where various corporates are in their… Like, as a practise owner, I’d have no idea where a corporate is in its cycle, so to speak. How did you find this information out? Is that something you’ve got insight to for any of the corporates, or…

Max: Yeah, we do have. My partners are incredibly experienced in the world of private equity and they have lots of connections so they know what’s happening and they can refer back to me. So we at Pluto Partners, this is for partners, essentially. I’m representing 25% of the partnership and I’m kind of the face of the business and I’m also going out and about, but we’ve got obviously as I mentioned the dentist, who’s the clinical advisor. The other two partners, they’ve got incredible experience and transactional knowledge so they know exactly what’s going on in the private equity world. So we do know there’s going to be some changes in groups coming very, very soon in this year, and there are talks about what’s happening also in 2022, which are groups that are preparing to serve, therefore they would boost their acquisitions campaign in order to prepare for a 2022 exit, providing no big changes are taking place.

Max: If you look at COVID, most groups will discount this as exceptional, so almost not even considering, like nothing ever happened really, because in the life cycle of a group or a private equity, six months or a year is nothing compared to 10 or 15 years kind of disruption. So this is what is happening, and again it’s what is driving valuations at the moment.

Max: So we see figures up to February, March 2020, and then we work backwards and I ask you also for the last three years of the account. Of course, we want to see what’s happening since the reopening. The situation is creating winners and losers. Typically there are now businesses who are picking up new patients from other businesses in dentistry and in other businesses, they are potentially partially opened.

Max: We see most of our clients in private practises especially, the revenue’s increased since reopening back in June and July and most of them, actually. And I feel that the new patients potentially will stay with the new practise, because they’re going to show a degree of loyalty that perhaps it wasn’t shown by their existing practise. Not to their fault, because they might not be able to operate in full so they are partially open. So this is what we see happening.

Payman Langroud…: COVID seems to have accelerated a few things, online shopping or whatever, but definitely that one. There was a bunch of people who were on the brink of becoming private patients or had enough money to be private patients, but were still being seen at their NHS place. Then when they couldn’t be seen there anymore, looks like that’s helped the private sector quite a lot. What are your predictions going forward? What do you think will happen with prices, maybe we’ll get you back in a year’s time and see if your predictions come true. What’s your prediction on prices, on multiples, on corporates, give me some of your… if you had to make a bet, what would you say?

Max: I think prices will stay the same and slightly improve, depending on a couple of groups exit multiple they will achieve. So what we saw in 2015, when Oasis Bupa deal happened, really boost prices for private practises, which at the time the multiple was about 1-1.5 below NHS prices, and after the Oasis Bupa deal private practises were selling on the same level of NHS practises, and this has kind of stabilised that.

Max: If we see large groups selling for multiples below 10, then of course that could potentially negatively impact valuations of single size, because as a single site, how can you ask a higher multiple than a group? Potentially there would be an argument from the buyers. I don’t think it’s going to be the case anyway, I think the groups will always sell for double digit and more in terms of multiple, I think we will see a couple of deals happening this year. I think one is going to be… it’s not too far from happening. I think we’re a few weeks away, which is going to change slightly the way the practises will be purchased and the multiple paid. I feel prices will stay the same and slightly increase during this year.

Payman Langroud…: Can you expand on that one or not? You’re not in a position to delve into that?

Max: The point I would like to make perhaps there is that another factor driving prices is demand. Demand is still there, and then of course if there is demand, which is still outstripping supply, it’s another factor that can also drive prices.

Payman Langroud…: Yeah no, but this deal you were talking about, can you talk anymore about that deal or no?

Max: We can talk about it next year. I don’t want to get in trouble.

Payman Langroud…: No, fair enough.

Max: I think it’s very confidential.

Payman Langroud…: Your business is all about confidentiality, there’s no problem with that at all.

Max: Absolutely.

Payman Langroud…: So the thing that we’ve been talking a lot about is on the selling side, but it’s interesting, your business, you’ve got these two totally different types of people that you talk to, right? You’ve got the young guy who’s just getting in and then you’ve got potentially the older guy who’s just getting out. But what I’m quite interested in is you know cats who are different to that model, people who I don’t know, you must have stories, people who buy a practise, sell it two years later at a profit or a loss, have you got any of those stories?

Max: I do, I have plenty of stories.

Payman Langroud…: Are any of those sellers flippers of dental practises? Do they exist? That that’s what they’re up to, they buy and sell.

Prav: Like houses?

Payman Langroud…: Like houses, whatever. Like shares.

Max: Yeah, there are, obviously. It takes time to improve on a business and I also have clients who buy a practise who think that just because they’re friends of a practise and maybe there is not that passion, and also it’s a profitable practise, completely change their life and pretty much ruined their relationship as well. So they come to me six months later saying, “I want to sell it, it’s a great practise, but I don’t want a divorce from my wife or my husband.” So you have to sell it sometimes to save your relationship.

Payman Langroud…: Wow. What about groups, like how fast have you seen people grow their groups? What kind of stories have you got there? I mean, I remember a guy in Nottingham, I don’t know if you guys have come across him, Dr. Sheikh. Do you ever come across this guy?

Max: Yeah.

Payman Langroud…: Fantastic guy. He had one practise, Prav, I don’t know, have you come across him, Prav? He had one practise, it was the size of Sainsbury’s, it was a gigantic place. Everyone in Nottingham will know this place. Is he still around? Has he sold his group? What’s he done? Do you know him? Are there others like him?

Max: I lost contact, but a couple of years ago I remember he was still around.

Payman Langroud…: So other groups, tell me about other groups, people who have grown groups and sold them to corporates. What kind of deals have you seen?

Max: I think what I see in the successful groups are the groups that put an emphasis, never on the profit, they’re groups that actually put an emphasis on the dentist first, then the patients, then the profit come after. We saw that when we were with ADP and I thought we were obviously buying for profit, but they were always treating the dentist fairly because there is nothing worse than going to a group, to a practise of a corporate, and then you’re always seen by a different dentist. You want some more consistency. Ultimately we also create underperformance.

Max: So the group that are more successful are the one that treat the dentist well and they don’t put a focus and an emphasis on just the profit and the cost savings, because automatically you will have no dentist to perform your business and your profit and practises will just go down.

Max: And as I said before, you make your money when you buy, not when you sell. So there is no point buying for vanity 20 practises and paying a 10 times multiple if you don’t have your exit multiple in mind, and if your exit in mind is only going to be 10, you essentially make less money with the 20 practises in your group than if you just own one practise and you’re running well. So it’s about doing it right. They used to say turnover is vanity and profitability’s sanity. So you’ve got to focus on the profit and you’ve got to focus on where you pay when you buy your practise, in terms of the group, and buy at the right price, really. Because then you will happy to exit and make some money.

Payman Langroud…: What are the most common mistakes people make when selling or when buying? What are the things you wish people knew? I mean that one that you just mentioned.

Max: The most common mistakes when selling is just accepting the first offer and just go for it without negotiating, without involving other groups and other buyers, because you might think you don’t want to upset this buyer because you might think it’s a good offer, but as I say you’ve got one chance, you want to make sure that you do it right. So you just involve… You can still do that confidentially, which we do sometimes, because we’ve got enough connections and buyers to bring to the table just to do an off the market conversation if that is the wish of our clients.

Max: But you need to involve six or seven good buyers because obviously you’ve got a price that is driven by your financial figures, and then you’ve got a price that is driven by what buyers are prepared to pay. And that you will never know that if you don’t involve more than one buyer. So that is the biggest mistake from a seller’s perspective.

Max: From the buyer’s perspective, it’s just buying on emotion and just overpaying for a business that you might end up working for free for the next seven to eight years, and then you just end up selling on a loss. So it’s about finding the right balance, really. And a good deal is always on a win-win basis. You want to maximise the price on the sellers and you want to make sure that the buyers are paying the right price, which is sometimes over the asking price, more often than not it is over the asking price, but not crazily especially as an independent buyer, which you will never recover the money that you would pay. So the biggest mistake for buyers is overpaying.

Payman Langroud…: You’ve been in the UK for the last, what, 14 years did you say?

Max: Yeah. I arrive on the 5th of November, 2005, sense the fireworks that you Brits are doing every year, thank you.

Payman Langroud…: What are the things you miss most about Italy when you’re here? I think I can guess, and what about the other way around, what do you miss about the UK when you’re there?

Max: That’s true, you know what, that is absolutely true. The thing I miss about Italy is something called [Italian 01:01:36], which is you go out for a walk and it doesn’t really matter about the destination, you just go for a walk and you meet someone and you say to them, “Let’s go for a [Italian 01:01:48],” which just means go for a walk and you just relax and you have a nice walk in the summer. That is what I miss because if I go out where I live, I’m likely to meet a fox or a deer but I don’t really see many people.

Payman Langroud…: Are you in Kent?

Max: Yeah, I’m in the countryside of Kent, but if you see someone outside university they come for a walk with me, they’re probably thinking this guy’s crazy. That is kind of what I miss. When I’m Italy, after a few days I miss the buzz and the things happening much faster and quicker than in Italy, in England. So I miss the things that they happen much quicker, which is why I love being here. I love being here because you can make a career if you are good at something. If you are good enough you don’t stay behind, you can make a career out of something.

Max: In Italy it’s more about who you know and it would take a long time and you might never get there. So I like the fact that in England, if you’re good and you work, you can be and do anything. So that’s what I love about it, that’s what I love about my adopted country.

Payman Langroud…: You’re saying it’s more of a meritocracy, it’s less about who you know and more about what you know.

Max: That’s correct.

Payman Langroud…: Yeah. I can see that happening in Italy as well. Coming from where I come from there’s a lot of that about, there’s a lot of that. Of course by the way, who you know is very important here too isn’t it? We mustn’t paper over that issue.

Max: Yeah. You can’t just rely on that, you have to work, and if you’re good you will succeed, ultimately. However, you’ve got to work for it. In Italy, you can see sometimes in positions of power not necessarily people who deserve to be there. That’s because it’s just about who you know, it can’t just be about that otherwise there’s never a progression into something good, really.

Payman Langroud…: How did you feel about Brexit when it was all going down? I know it all got superseded with COVID, but in that period how were you feeling about it?

Max: I never really got the point that people were talking about racism or anything like that. The only thing is that I hope that it won’t change for people like me who are able to come and have, I like to say, kind of a successful career and life and establish myself in England. I hope that people will have the same opportunities that I had in the future. So that’s the thing I really hope. In terms of [crosstalk]

Payman Langroud…: Italians won’t, will they? If I’m an Italian who wants to come to the UK now, I’ve got the same chance as someone from Nigeria who wants to come to the UK now. So that has changed, hasn’t it?

Max: It is, yeah. So hopefully it won’t deter people coming because there are many opportunities in this country that might not be in other countries, if you like this sort of lifestyle. So I hope in the future it won’t change too much. I know it’s changed a little bit. So we’d like to just wait and see, really. So that’s my only thing, really. And in terms of being your master of your own destiny and things like that and the £350 million on the NHS. They’re all promises. I don’t really want to go into politics too much, I just hope that people will have the same opportunity that I had in the future because we all deserve it really. If you want to go for it, I don’t see why we need to have an opportunity as you want to have.

Payman Langroud…: You think you’re going to carry on… I mean, I’m sure you are for the meantime you’re going to do this, but do you think you’re going to make a move back into corporate dentistry at any point? Are you going to be with a friendly Russian billionaire opening your own corporate chain? You’re perfectly positioned for that.

Max: Do you know over the last couple of years, I had several offers working and going back in those M&A acquisitions at director level or partners level. I have a massive degree of loyalty and respect and trust to my partners. I want Pluto Partner to succeed. I know we will, I know we are bringing competition into the marketplace, which is a great thing, because competition makes people less complacent, less lazy, and that’s what we like to do. I want, and I will, make Pluto Partners a success and that’s my only focus right now.

Payman Langroud…: Yeah. But will Pluto Partners itself change other than practise broking? Do you think going forward you guys are going to do other activities?

Max: Yeah, that is the plan, that is the long-term plan. So if you just think about Pluto, instead of being a planet or a rock, think about Pluto as the sun with other services orbiting around Pluto Partners. So we have in the pipeline in 2021 and 2022, kind of a subsidiary businesses coming at the back of Pluto Partners all linked and related to not just dentistry but healthcare. So we are in the process of expanding, so we grew year on year since we started two and a half years ago, we have our pipeline now is stronger than ever, and I’m very pleased and grateful for this, and we’re just growing by adding additional services to dentistry first, and then to healthcare after, because my experience again is not just dentistry but it’s also in a GP practises. Nick Rolph has experience in pharmacies and vet.

Max: So at the moment, we are taking our experience to provide a different service to dentistry but we then want to then expand and going back to other healthcare services, so that’s the plan going forward.

Payman Langroud…: Sounds great, man, sounds great. If I sell my-

Max: [crosstalk] that’s the main thing really.

Payman Langroud…: If I sell my practise and get £2 million for it, whatever, would you guys help me invest my money as well? Have you got that side of it? The well management side?

Max: We do, one of our partner, one of the four, [inaudible] company providing a wealth management service, he’s got lots of dentists in it, so that’s something that we provide, wealth management advising on freehold, commercial freeholds, [inaudible] disposal and accountancy part of it, tax services. Yeah, we do, we can help. Not me personally, but we’ve got experts that can help on how to best invest and spend the money.

Payman Langroud…: So I don’t know if you’ve listened to this podcast before but Prav likes to end it with his final question.

Prav: So Max, it’s been great speaking and I know from personally having conversations with you that business aside, family and health are incredibly important to you and I see that on your social posts as well as the conversations we’ve had. So I’ve got a final question I usually ask at the end of the podcast, a couple of questions, then I’ve got a new question for 2021 as well. So you’ll be the first one we’re testing this out on Max. So first question comes back to imagine it’s your last day on the planet and you’ve got your loved ones around you, and you need to leave them with three pieces of advice. What would those pieces of advice be? Secondly, the second question is how would you like to be remembered, and then the third question I’m going to let you know after you’ve answered those first two.

Max: Okay. Travel the world, live your life with passion, and eat good food in good company.

Prav: Beautiful. So all that revolves around enjoying your life. Me and Payman had a discussion about this yesterday, didn’t we? If someone was to summarise your legacy, how would you like to be remembered Max?

Max: Something like what would be written on… oh, he was something like… Max was, something like that

Prav: Max was, yeah, Max was… Finish the sentence.

Max: Max was only 100 years old.

Prav: Awesome. And then my final question-

Max: Okay, very important to me Prav, Max a good father. So that would be the best achievement, really.

Prav: Yeah. And listen, I kind of know that from the conversations we’ve had and the passion and everything, it all revolves around family. So my final, final question is this. You’ve got 12 months left on this planet, you know that, it’s a fact, yeah? How’s your life going to change over the next 12 months, what are you going to do?

Max: I actually continue to do what I’m doing because a couple of days ago it was my birthday and I started the day and I had a day and I absolutely did, it was a special day, but you know what? It was like the day before and the day after. So I had my kids come in and nagging me, I had my wife next to me, which I love and adore. I have everything I need and I’m doing something I really love doing, I found my passion and I kind of developed it. So I carry on doing what I’m doing.

Payman Langroud…: What if you only had 12 days left, would you go to work for those 12 days?

Max: Yeah. And I probably ran more than anything, maybe do more stuff with my family really. In terms of work, I don’t kind of-

Payman Langroud…: What about 12 hours, if I said to you you’ve got 12 hours left, would you go to work for nine of those?

Prav: I know what Payman would do. I’m going to take that secret to my grave.

Payman Langroud…: This is a new question, I like this new question, but go on, go on. I like what you said.

Max: As long as my kids are with me and we’re doing something together, then it doesn’t really matter. I’d probably go on a cruise ship, actually, I’d go on a cruise.

Payman Langroud…: Oh, that’s nice.

Prav: Nice, nice.

Payman Langroud…: That’s nice. I think we’ve got to work on this question, man, 12 months is a long time. It just feels like a long time. You’ll get that answer from a lot of people, man.

Prav: But I think, you know what, if you were to…

Payman Langroud…: One month, one month.

Max: Here is my answer then. I’d go one month, I take my family, my mum and dad, my kids, my wife, and we go on a world cruise.

Payman Langroud…: Lovely.

Prav: Beautiful.

Payman Langroud…: Lovely, lovely. Prav, we’ve got to close it but Max, this has been just really lovely having you on. Hearing your backstory has been wonderful and then diving heavily into what’s going on right now, you’ve been very open with it so it’s been an education. Thank you so much.

Max: My absolute pleasure. Thank you.

Prav: Thank you Max, thank you.

Speaker 2: This is Dental Leaders, the podcast where you get to go one-on-one with emerging leaders in dentistry. Your hosts Payman Langroudi and Prav Solanki.

Prav: Thanks for listening, guys. If you got this far you must have listened to the whole thing, and just a huge thank you both from me and Pay for actually sticking through and listening to what we’ve had to say and what our guest has had to say because I’m assuming you got some value out of it.

Payman Langroud…: If you did get some value out of it, think about subscribing and if you would share this with a friend who you think might get some value out of it too, thank you so, so, so much for listening. Thanks.

Prav: And don’t forget out six star rating.

 

 

After graduating in 1994, Sanjay Sethi quickly made a name as a leader in aesthetic dentistry. So, when brother Nik graduating almost two decades later in 2009, expectations were high.

In this week’s episode, Payman gets the brothers together for a frank conversation on their early years; how each followed their own unique career path; the highs and lows of working together, and much more. 

Enjoy!

“I think really we’ve been, on balance, really good because we have our own strengths. And yeah, there’ll always be some differences we’ll have along the way, and I’m not going to deny that. But on par, it’s sorted out on the day and we just move on. We have a laugh. We have a great time together!” – Sanjay Sethi

In This Episode

01.08 – Backstory
07.54 – On excellence
09.54 – Influence and associations
19.02 – Heroes
20.27 – Sharing work
23.55 – Square Mile
25.38 – Expectation, motivation and inspiration
35.51 – Buying in
38.55 – Friends vs colleagues
40.40 – Dark times and COVID
41.20 – Pricing
46.53 – Teaching and lightbulb moments
50.00 – Clinical mistakes
54.30 – New practise
57.44 – On family
58.46 – Digital dentistry
01.06.51 – Predictions
01.17.52 – AEsethiX
01.20.28 – Last days and legacies

About Nik and Sanjay Sethi

Brothers Nik and Sanjay Sethi are co-owners of Square Mile Dentistry in the City of London. 

Sanjay graduated from Guy’s in 1994 and pursues a special interest in aesthetic and restorative dentistry.

Nik graduated in 2009 from King’s College London and is passionate about composite bonding and smile makeovers.

In addition to Square Mile Dentistry, Nik and Sanjay also co-own a practice in Essex and the AEsethiX dental training academy.

 

 

Sanjay Sethi: Knowledge is nothing without application. It doesn’t matter what you’ve learned. You can have all these facts in your head, but if you can’t apply it, whether it be in dentistry in life, life lessons, whatever, it meant nothing, did it? And you don’t want to be sitting there full of regrets. So you’ve got to apply and evolve all the time.

Speaker 2: This is Dental Leaders, the podcast, where you get to go one-on-one with emerging leaders in dentistry. Your hosts Payman Langroudi and Prav Solanki.

Payman Langroud…: It’s my great pleasure to welcome Sanjay and Nik Sethi, onto the podcast. Some of the brothers in arms, brothers in the industries, there’s a few groups of those. Isn’t there? Good to have you guys.

Nik Sethi: And thanks [crosstalk 00:00:54].

Payman Langroud…: It’s weird Nik because I didn’t know you existed until you became a dentist. I have known Sanjay a long time-

Nik Sethi: He tries to keep me under, [inaudible] secret.

Sanjay Sethi: But at least, I’m not going to hold him back.

Payman Langroud…: What is the age difference between you guys?

Nik Sethi: Do you want to tell him?

Sanjay Sethi: 14 years. I was working out today actually, when I first went to uni back in ’89, he was only three years old.

Nik Sethi: And I remember actually I used to guilt trip him. Because Sanjay is like another father. Growing up, we were all super close to our dad as well. But he being 14 years older, he was like another dad. And it would be a Friday night when he’s 21, he’s getting ready to go clubbing. And Sanjay used to have this really real wild hair. And he must have spent more than an hour with the hairdryer, with the Brew cream, having it all up and ready to go. And then I didn’t want him to go out, so I went to play. And I’ll keep guilt tripping him. He’d leave. And then, because I’d be crying, literally about 10 minutes later, drive back and come in and cancel the night just to… I wouldn’t have done that for anyone when I was 21 going out clubbing.

Payman Langroud…: Was it just the two of you?

Sanjay Sethi: Just the two of us, yeah.

Payman Langroud…: Is your dad or your mom, or your parents involved in dentistry or how did it happen?

Sanjay Sethi: No. No, not at all. My dad’s sister in India, she is a dentist. But that had no influence on me. I think it was just one of those things. When you grew up is the standard Indian profession, isn’t it? You’ve go doctor, dentist, lawyer, accountant, and I wanted to do medicine really, but I just didn’t like the idea of people dying on me. So then I thought the next thing was dentistry and that was literally how I fell into it. So I went and watched people, like my dad had a few friends. I went and watched them and that was how I got into it, but I didn’t know much else.

Payman Langroud…: So a lot has happened. But Sanjay, I remember I came to a lecture once where you were lecturing. I don’t know where it was, man. It might’ve been one of the first FMC events or dentistry show, one of the first ones. And I remember it was the first time where I saw a composite that blew me away by a UK lecturer. I had been in America once, but it just blew me. I think it was a Durafill composite.

Sanjay Sethi: Payman, you’ve got a really good memory. Yeah.

Payman Langroud…: Like a highly polished, invisible, composite and up to that point. I’d never seen that before. And you were very active on the lecture circuit at that time. I mean, you were the composite guy.

Sanjay Sethi: Yeah. I got a name for doing composites in this country. I kind of just fell into it. I was very lucky with how I was brought up and how my career developed and I fell into the composite side of things. I was doing everything, but I was gradually expanding with all other sides. But you get known for doing one thing. I liked teaching composites. I still like teaching composite stuff. I think it’s a great topic. Well you’re passionate about composites, as you know.

Payman Langroud…: Yeah. I’ve gone that way now, but at the time you were the undisputed King. It was ages and ages ago man.

Sanjay Sethi: They gave me up too much now, I just-

Payman Langroud…: It was before Jason was around, it was just a long time ago.

Sanjay Sethi: I’ve got a lot more grey hairs than most, so yeah. It’s funny how your memories will make you seem even better.

Payman Langroud…: How did you fall into it? What was the story with that? Did you go abroad or something?

Sanjay Sethi: I was really lucky. My story started when I finished my VT and I met a guy who said, “Look, come and work with me. I’m in NHS and I’ll teach you how to make money.” So I thought, “It doesn’t sound quite what I want to do, but I want to learn dentistry. This guy seemed to be doing everything.” So I went to go and work with him and he said, “Look, come along. There’s a conference this weekend. We’re going to go clubbing here. We’re going to do this. We’ll go to this conference.” And I just by accident, I said, “Well, I’m going to go.” Because I just fancied going out that weekend. And I had nothing else to do. And we ended up in this place just North of Leicester called Belton Woods. And it was a BAAD Conference, British Academy of Aesthetic Dentistry. And I didn’t know anything about it. It was their secondary year. And I walked in and the first lecture just blew me away.

Sanjay Sethi: And I honestly felt like leaving dentistry because these guys were doing provisionals and I didn’t even know what a provisional was. And I thought, “I’m just qualified. I should know everything.” And I just wanted to do what they did. And I literally started from there. So met some of the guys and they were really good to take me under their wing. I was fortunate to have my dental dad, as I call him Tidu Mankoo. He allowed me to shadow him for a long time and then do his year programme. And he since then has always mentored me. So it’s been great to have him for his support. And then a number of other guys throughout the Academy have just taught me Lambert Fig, Shane Gordon, David Winkler, so many people. And then from there, you branch out. They always have that saying, if you surround yourself with excellence, you adopt that way of thinking and things happen to you. So I fell into that and I just happened to start watching people doing composites like I never thought could be done. And I thought, “Well, I want to do that as well.”

Payman Langroud…: Did you go on courses?

Sanjay Sethi: No, I did loads of… At one point, I think I did every course I could get my hand on. Literally, if I had the time, I’d literally be spending 10s of 10s of thousands-

Payman Langroud…: There weren’t that many courses back then I remember-

Sanjay Sethi: You had to go abroad. Everything was abroad. We’re spoiled now.

Payman Langroud…: Which year did you qualify Sanjay?

Sanjay Sethi: ’93. December ’93.

Payman Langroud…: Yeah, so I qualified ’95. And I remember thinking, “I want to be a cosmetic dentist and go on a course.” And there was only two. There was Howard [inaudible 00:06:40], I don’t know if you remember him. He had this sort of thing where he would test materials out or something. But it was called a cosmetic course. And then it was Larry in New York.

Sanjay Sethi: Yeah. That’s what I was saying. Everything was abroad really. I did most of my stuff abroad because at that time we weren’t as spoiled, those speakers didn’t come over here that often. And so you’d go to them or you’d go to these big conferences. But I think that was part of the journey. Wasn’t it? The fact that you were doing something different, but then trying to apply it back here was hard. You weren’t given that… I was in NHS practise back then, not now. I used to look really young. I barely could get into a bar without showing my ID, let alone trying to sell any high-end treatment to anyone. No one would believe me.

Sanjay Sethi: So I’d try and get jobs in private practises. And no one would employ me. I went to some really good places. And eventually there was this one guy who was holistic, Tom Nyerges, he was in Luton and he took me on to do one and a half days a week. And that’s when I started to get my hands in. And like I said, all the time, I was just getting all this knowledge and just soaking in, soaking in, and I just wanted to do it. So I’d practised in all my NHS practise patients. So my boss hated me because I had no money.

Payman Langroud…: But where do you think it comes from? Both of you have got this excellence idea. Like you want to be the best. And when I’ve even spoken to you on this course of yours, that you guys… We’ll get to it, but this is AEsethiX thing. And I was saying, “Well, how are you making the numbers work and all this?” And you were going “Well, the number’s not really what we’re interested in, we’re interested in the learning for ourselves.” Where do you think that comes from? Is it your dad? Where does it come from? Why do you want to be the best and not the biggest and the richest or whatever it is. Where did the quality thing come from? Both of you have it.

Nik Sethi: We’ve got amazing family of people around us, but I think that actually comes a lot from Sanjay. Naturally, I’ve got a good brain. I’m quite academic. I love reading. But Sanjay’s passion to just be the best he can be, but not just for the sake of being that, to deliver the best for his patients. And he’s one of these people that he may not, and he won’t mind me saying this, he may not get something as quick as maybe I do academically, but no one will work harder than him to then practise, practise, practise, practise. There’s no secret. Whenever people say, “How do you do this? How do you get your composite looking like that? How do you do that? As you know Payman, there’s no secret. You’ve got to follow protocols, meticulously. You’ve got to time things. If you’re told to X something for a certain number of seconds, you get a timer and time it.

Nik Sethi: And this is what Sanjay did. He took every little part of the protocol and just practised it religiously, again and again and again. And he would breathe down my neck when I first tried at Square Mile. And every day I’d have to show him before and after, and he’d have my nurse spying on me to tell him where I was going wrong. And that’s honestly the kick up the butt that I needed. But it’s how he lives. Literally every single day. Just learning, practise, practise, practise, practise.

Payman Langroud…: How much of an influence was Sanjay in becoming a dentist for you Nik? Did you Sanjay, did you actually plot and say, “I’m going to turn him into a dentist.” Or how did it happen?

Sanjay Sethi: I think when he was about 14, 15 years old, he won’t mind me saying it. Man, we didn’t even think this guy was going to get any GCCEs. We were worried, where’s he going to end up? We thought like, “We’re going to start having to look at something to set him up with.” Because we didn’t know what he… He was just wanting to play sports. And he’s always been full of life. And then we were just chatting and I said, “Look, I can’t help you with much in terms of business or whatever, but the only thing that I could give you direction in and give you the head start.”

Sanjay Sethi: Like me and you Payman, we went through the hard way of learning because that was all we had. We didn’t have any other routes really. And at that time, institutionalised academia was not necessarily the way to do the high end dentistry. Not that there’s anything wrong with it. I’ve really learned to appreciate that so much more as the years have gone on. But all I said was, “I think that’s the only thing I can help you with.” And he was literally like a son to me. And he just looked at me, goes, “Yeah, all right then.” And that was it. I don’t think he really knew what he was getting into. Because he goes, “Yeah, all right then.” But then suddenly something clicked in him and he just started getting amazing results and just excelling.

Payman Langroud…: Nik what about from your side. How did that feel? Was that how it went down?

Nik Sethi: He’s absolutely right. When I was, 11, 12, 13, all I wanted to do is play tennis four or five times a week. That was all I wanted to do. I had no interest. Then I had a hip injury and I had to have quite a major hip operation. I was homeschooled for a year, I missed the whole of year nine. And through support of the family, I had a great life. I just got to stay at home, playing PlayStation every day, which was brilliant. But I had an amazing tutor that was given to me by the local council to help me with schoolwork. And he just allowed me to see certain subjects like chemistry, biology, and make it relevant to the competition of having myself when I was playing sport. And suddenly I loved it.

Nik Sethi: So then I just got fully into education, from being literally in the bottom set of everything. Then I ended up being straight A’s GCSE and the same in A-levels. And I just got obsessed with it, but I can’t lie to you and say, “Dentistry was my path.” I was very torn between medicine, dentistry and economics. And I’ll be honest, Sanjay said, “Come and watch me for a day.” And when you’re watching someone spending an hour and a half on a composite and you don’t know anything about it. It’s really boring. I remember thinking, “There’s no way I’m doing this for the rest of my life, man. This is crazy. I should have gone to watch the NHS practise.” But I just thought, “Well, if I did dentistry, if I didn’t like it, it’s a great degree to have. I could then branch out and do something else.”

Nik Sethi: And as I then went through the degree, I started to have a much deeper appreciation with the biology, the chemistry, the actual understanding of the human body. And then once I’ve qualified, similar to Sanjay, I had Sanjay’s influence, which was monumental in my career and still is to this day. But the British Academy of Aesthetic Dentistry, again, Sanjay forced me to come. I didn’t want to go, I didn’t want to go to a conference. And the first lecture I saw, it couldn’t have mapped out my career better. The first two people I saw to back was Didier Dietschi talking about posterior rehabilitations in composite and Kenny Malament talking about posterior rehabilitations in e.max crowns.

Nik Sethi: And I was sitting there watching both of their arguments and thinking, these are both incredible Kenny Malamed talking about the cycles of lithium disilicate at the time, which was pretty nudity e.max at that time. And I thought this is amazing, but very destructive in some of the cases that it has been prescribed for. And then you’ve got Didier Dietschi who was taking a putty essentially in his hands and making a masterpiece. And I remember thinking to myself, “Okay, I appreciate these guys both, but I know where I want to lie on this spectrum.”

Nik Sethi: And it was very much towards the adhesive more minimalistic conservative way. And that, Sanjay’s influence and the people around BAAD just helped me feel protected in this environment of excellence. I was never allowed to learn bad habits. I was very lucky to have people around me. And that’s one of the things that a lot of young dentists miss, I think is that mentorship, that camaraderie that an Academy or having a-

Payman Langroud…: I think BAAD was very influential in my thinking as well. And it’s in a very similar way to what you’re saying, I went very early to a BAAD. And just all the way from the quality of the AV to the quality of the audience, to the quality of the speaker. And you know that feeling that I used to get all the time at dental events was, “Why can’t the coffee be a bit better, man? Why can’t the bloody screen be a bit better, man? And then when the lecturer’s speaking, why can’t they bring up slightly a better lecture?” Everything could have been a bit better. And then I remember going to BAAD and thinking, “Oh, it actually exists here where the quality is higher.” And then when BACD came along, and it was a bit… I don’t know you guys, what your feeling on why that came along and how it felt like BAAD was difficult to get into or something, was that sort of feeling, but it isn’t. But I think that was the feeling. You have to be recommended or something. Was that the thing?

Sanjay Sethi: No, there was a whole… I think that was the thing is, it was difficult to understand and maybe it wasn’t made clear at the time, clear enough. But it felt like people thought we were being maybe a bit too selective. But there was a thing you could come along, you could be invited as a guest. And then if you want to apply to join, you’d have to be sponsored by two people there-

Payman Langroud…: It was just old school golf club way of doing life things.

Sanjay Sethi: It was like that kind of thing. But I think it got a bit maybe misinterpreted and I think BACD did a wonderful job. I think what they did was, they took on everybody and they catered for everybody, which is the hardest thing to do. To make everyone happy in a room is probably the hardest thing to do. And there was some brilliant guys back in the day, what Chris Orr achieved and started from to make it the second or third biggest organisation in the country? It must be, after ADI and BDA must be. I think it’s phenomenal, the job that they’ve done and the guys that are on there, many of them have been my friends from the start and I’ve got many more friends from there. So actually, we’re two different entities. And I think BAAD knows where is that. We’re not looking to take thousands of people, but everyone’s welcome to come. If you want to come to us, some people, they don’t feel it’s for them? And it’s just one of those things. But I think it has its own special place.

Nik Sethi: Over the years, there’s less of that golf club mentality now. It’s got more open door. The energy there is fantastic as with the BACD, both fantastic organisations. And especially it’s been instrumental in my career. And I was a no one when I started, and I was welcomed with open arms. I know many people have benefited. Nowadays, you can’t afford to have that attitude where you’ve got to be selective. Everyone has a right to learn. Everyone has a right to have their journey to become the best. It’s not the Royal family for God’s sake. Everyone has a right to do the same. We’re all doing the same career. We have the same rights. So I think the BACD, BAAD, even the therapist academies, they’re all working towards the same mission of providing that safe network to expand. And like we discussed off air earlier, talking about your errors and failures, which it can be daunting to discuss with your fellow professionals talking about failures.

Payman Langroud…: Yeah. It’s a shame that these things become factional sometimes but from my perspective, Enlighten became very involved with BACD and not so involved with BAAD. Simply because of no follow-up, no one came and said, “Do you want to buy a stand at BAAD, ever. And you know how it is, if someone comes to you and says, “Do you want to buy a stand?” And then follows you up and so on, you end up just going that way. That’s why follow up works so well. But, what’s interesting for me is when we get calls to our office, people say. “I’m just thinking about a composite course. I’m thinking about coming on Depeche’s course, or I’m thinking about this other one.” And almost like, “Sell it to me tell me. Tell me why yours is better than the other one.”

Payman Langroud…: And the way I always say to them is, “Go on both, go on three or four.” The way you guys think about education, I’ve noticed, particularly Nik now, it’s almost like you’re constantly in education. And if I want to be the best composite guy, and let’s just say in my practise, it’s going to take more than coming to one course. I want to be the best composite guy in my postcode area. And then it depends on what you want, man. Some people want to be the best composite guy in the country or the world or whatever. You better go to a few courses, man. You better go to a few courses. Deciding whether to go to PACD or whether to go to BAAD, if you want to go anywhere, do both. It’s the way I would-

Sanjay Sethi: Have you ever watched that series, Heroes?

Payman Langroud…: No.

Sanjay Sethi: There was a guy there who had no powers, but his one power, which he did develop was to absorb other people’s powers. His name was Peter Petrelli. So that’s exactly it. The more courses you go on, the more you absorb and your idea is to absorb all of their superpowers and make it your own. And that’s literally how you can become the best or the best at whatever you do or in your practise or whatever. So it’s going back to that way of thinking. I 100% agree with you. If you just do one course, you’d only have one way of thinking, one way of doing it. And when you’ve got another problem that doesn’t solve that issue, that course didn’t fill you, if didn’t fill your whole world up with how to resolve different problems.

Payman Langroud…: You guys now in the practise, I know Sanjay you’re involved quite a lot with implants as well, do you guys in a sort of organised way, decide, “All right, your implant… So, Nik’s not going to do the implant side and Nik’s going to do the minimally invasive side.” Is that how you actually think about it? Or do you think about it more like you’re going to have to learn it all of you, both of you are going to have to learn it.

Nik Sethi: That’s a really good question. So essentially for the first few years, Sanjay maybe do everything. I have to learn it the way Sanjay understood it. And I had to then obviously bring on what I knew from courses and learning. And I was doing the endos, the perios, I was doing composite, everything that Sanjay sew I did. And then before I started getting into surgery and implants, I suddenly thought to myself, “Well, I’d love to be a partner in Square Mile one day.” I love the practise dearly. It’s been such an instrumental part of my life. I love the team there. I love everything about the practise. And I thought, “Well, if I’m going to be a partner here, it doesn’t make sense to be exactly the same as Sanjay because Sanjay is Sanjay. He’s got his patient base for 20 years and why be exactly the same?” And so we then had a good discussion and I decided, “Well, I’m not going to go down the implants route.” Never say never.

Nik Sethi: But Sanjay, I’ve got a good knack with restorative dentistry. I’d like to think that I can produce nice results now, always learning. But for me to then get to that next level to where Sanjay surgically, that’s a whole another career. And what Sanjay has developed with his handling of soft tissues, it’s not just placing an implant in. His provisionals, he’s handling of soft tissue grafting, it’s such a niche, that I think he’s so good. Why do I want to go down that path? He’s the man. So the idea is now to pull. And recently we have been, Sanjay doesn’t do the endos. He doesn’t do as much of the composite stuff. And refocusing more on the surgery. I take on more of the adhesive ware cases. We’ve got wonderful clinicians in the practise. We’ve got Elaine Mo who comes on and does-

Payman Langroud…: I love, she’s seriously very good.

Nik Sethi: She’s the shining beacon for the next generation. She’s amazing. And her energy. And she does exactly what I do. She treats the practise like her own. She’s the first one in, she’ll stay well late. She’ll help the girls clean up. She-

Payman Langroud…: When we did that hands-on in Square Mile with Depeche, Elaine was on her hands and knees cleaning up, doing my job.

Nik Sethi: She is part of the family, she gets stuck here. So it’s exactly how I always was. So it’s been wonderful. So she does the ortho restorative and the composites, and we’ve got Amit Patel who-

Payman Langroud…: Yeah. Amit’s there.

Nik Sethi: TC’s son. So Amit comes on and does more of the prosthetic work with his university training. And he’s got some fabulous skills. So between us, we’re now differentiating and hopefully going to turn our practise into more of a referral base where we can teach dentists around us to improve their daily dentistry because we’d love to do that. And if there’s certain cases, they feel that they’re not comfortable with, they know that they’ve got us around the corner to be able to then help them and then send the patient back once our GT’s done.

Payman Langroud…: Sanjay, take me back to when you started Square Mile, because back then the idea of a practise in the city was quite innovative thinking in itself, wasn’t it?

Sanjay Sethi: Yeah. You know what it was for me was, I realised that no one’s really going to employ me in a private practise. Like I said, I just looked really young. And the only way that I was going to do it was to get a practise, but I didn’t have the balls back then to just go and buy it on my own. So I bought it with a friend of mine who is in the year below me. Selema Podany, unfortunately she’s now passed away. So it’s really sad. But we bought it together and we took a practise and just did the dentistry that we wanted to do.

Payman Langroud…: It was an existing practise?

Sanjay Sethi: Sorry. It was an existing practise, yes.

Payman Langroud…: Oh, it was. Okay.

Sanjay Sethi: It was a private practise. It had been there for about 12 years, but again, it was like one of those things, whoever had taken over it never developed it. And then I took over it with Selema and few years down the line, then I bought her out and then took it in the direction I wanted to go. I just wanted to keep going in this pathway no matter what. My thing was, it was just a journey. And it was like my excuse to practise the best industry. My philosophy has always been, money can’t buy you contentment, but ultimately we’re health professionals. And so as a health professional, we have a duty of care. I think dentistry can be seen as a business and healthcare, but it’s got to be healthcare first. And so taking all of that side of things, what you realise is when you want to try and do what these guys were doing on the stage, and I was learning from, it’s not easy, it’s really not easy. And that last little bit is painstaking to achieve. And the only way I could do it was if it was in my practise. Now if I was prepared to take a bit of a loss, not great business sense.

Payman Langroud…: We just had Tom Young’s on the podcast. I don’t know if you remember him either of you, but he was one of these young guns who was really into it. And then he’s quit dentistry. And he was saying the idea that the better job you do, the less money you make. Was really annoying to him. And it’s a difficult thing because, let’s say a lawyer the alignment of the patient goal with the dentist goal is the ideal situation. Isn’t it? That you can say, all right, this thing’s going to take me three hours or whatever it is. And I’m going to get paid for my three hours. But we know because we work in that, “20 years. Is this thing I’m going to doing now, when is it going to fail? And what can I do to minimise that and make it a 30 year.” But you can always do a bit more, can’t you? And he was saying that that used to just break him. The idea that that’s the situation

Sanjay Sethi: A 100% agree with them. But every time I go in with that thought, as soon as I’ve got someone in front of me with their mouth open, I just have to deliver. The way I see it is like, if you’re saying-

Nik Sethi: Careful how you say that, buddy.

Sanjay Sethi: I’m not going to rephrase it, but yeah, you get what I really mean. Yeah. But, you just have to deliver. I just always thought of it that if Usain Bolt is expected to run under 10 seconds every time, the 100 metres, that was his standard. And if he ran more than 10 seconds, that was a really poor race. So my idea of not trying to break the world record every time was to try and run that. And yeah, it came at a price, but you do get better. You do get quicker, but you might not be putting Ferrari’s in your front drive. And I totally get that way of working. It’s not for everyone. There’s no one course which fits everyone. And there’s no one way of being a business-minded that fits everyone as well. I’m not saying it’s the wisest thing, but for me, it was just right. I did it-

Payman Langroud…: I feel like we’re really lucky guys here. Because it’s a difficult job. By the way, I don’t practise anymore, so I know what I’m saying. But it’s a difficult job but there’s a bunch of us, or a bunch of you who adore their job, love their job. So what would you say for you, is the thing that you love most? Is it that? The fact that the trust issue… That’s the way it’s coming over Sanjay. This person’s come and he’s trusted you with his health and you take on that responsibility or is it the Meccano side? Some people are really that way involved. They want to put bits together. You implant guys that are a bit like that. Or is it this minimally invasive? For me, when I was a dentist, I used to enjoy just meeting people. That was my favourite thing about it, talking to people and all of that. Well, what is it for you?

Sanjay Sethi: Nik? Do you want to go?

Nik Sethi: I think I know what it is for you mate. Because it’s the love of what you do. Of course, you love meeting people, but Sanjay will go… We’ll have a business meeting, which the aim of it will be to discuss how we did last week and how the practise took last month. And within five minutes, we’re talking about a grafting case. And, “How I manage these like…” “Oh, you should have seen the suturing. It was just amazing. I was so happy how it came down.”

Sanjay Sethi: I sounded really sad though, don’t I?

Nik Sethi: [crosstalk 00:28:57], do it later. I’m like, “Yeah. That’s great. So shall we…” But that’s what he’s always the most to you, I say. Is just-

Sanjay Sethi: Yeah, I just found it addictive. I’ve always found it addictive that if you can achieve something, then you want to try and do better. My thing was when I first qualified and started getting to his courses, these guys at BAAD that were my mentors, my initial mentors. And since then I’ve had many, were all BDS. Hardly any of them had a postgraduate qualification yet they were blowing professors and teachers all over the world, out of the park with some of the dentistry that they were doing. And they were just BDS. So for me, what I learned was if my eyes and hands can do what my head is being told, then I’m on to something and if they can do it and they’re just BDS, well, then any one of us can do it. And that’s the way I’ve always taught it, that there’s nothing to stop anyone from being able to achieve it. But it’s, “Can you achieve it every day, day in, day out?”

Nik Sethi: For m it’s slightly different. I love the dentistry. I love the chemistry behind it. I love the science. I love the adhesions side of it. I love looking at the light curing. So the teaching for me, my future, as much as I love clinical practise, I do believe that my future lies in academia and teaching. And that’s why the education Academy stuff that we’re trying to do is very close to my heart because it’s just what I find lovely. Seeing the light in someone else’s eyes when they’ve understood something that was taught so complex, like occlusion or adhesion, it’s some myth in university. And even to this day, when I do a composite course, the first thing I always get asked is, “How do you get your composite so shiny?”

Nik Sethi: And I say, “Let’s forget all of that. What bond are you using?” Half the room won’t know. “What light cure unit are using? What’s the wavelength? What’s the power? How far away are you from the thing? Answer me these questions first, because these are the building blocks to everything else that you can achieve in the rest of your career.” And so shining the light where I have been so lucky to be taught by incredible people for me, that is so inspiring and I’m always learning from that. So that’s probably what I love the most about my career. Is being involved in that side of things.

Payman Langroud…: Who are the people who really inspired you? Sanjay mentioned to do, and I’m sure there’s others. But who are the people for you Nik?

Sanjay Sethi: Man, there’s so many, UK based, I would say you’ve got fantastic people. You’ve got Gavin [inaudible] doing amazing composite. And actually, I have to say, even though he’s my age, or maybe a year younger, even watching Depeche really, really inspired my love for anterior composites. And that’s what I’m known for doing. And I was really proud of watching Depeche, considering all the lovely things he said about Sanjay in the past and learning from Sanjay, it was really nice to watch Depeche absolutely nail what he does. It was fabulous. And then on the more prosthetic side of things, I suppose I went to watch Mauro Frediani last year in Italy, 12 days, and bear in mind I’m 10 years in. And it made me rip up my rule book for treatment planning totally. Just to see things in a whole different light about how to treatment plan a patient properly from start to finish, how to charge properly for it and believe in that. And also how to meticulously make sure you’re doing what you’re talking every single step of the way-

Payman Langroud…: It’s a 12 day course, is it?

Nik Sethi: The 12 day’s masterclass. So you go there for three months and you do-

Sanjay Sethi: That was three months?

Nik Sethi: Yeah. Three, four days at a time, he was fabulous. But in the UK, again, the A courses have been on Basil Mizrahi for me. He again reminded me a lot of Sanjay. Yes, he’s doing great for himself. And he deserves to, but he really punishes himself on the standards he expects. The temporaries, the finals, and you can tell even when he shows a case, he never shows a case and says, “Isn’t that amazing?” You can tell what he’s looking at. And he’s thinking, “I just wish…” And it’s that. That for me inspires me.

Sanjay Sethi: You never want to see someone break down a case more than Basil Mizrahi, I’ll be really surprised because that guy is phenomenal the way he breaks it down. Even the number of stages he takes to do just one or two things, let alone a rehab.

Payman Langroud…: Yeah. And we’re having him on actually. I’m looking forward to having him on.

Sanjay Sethi: He’s awesome.

Nik Sethi: But it’s not just dentist for me Payman, I have a massive amount when it comes to communication with people and not just patients, but also other dentistry teaching from the trade. So one person for me that deserves a big singling is David Ultram. He was obviously a managing director of Optident. Now a big part of Henry Schein. David Ultram, funny enough, I met him at that first BAAD conference I went to in 2011 and we just started talking at the bar and I had no idea who he was. We just really got on. And a couple of days later, he got my details from Sanjay and we met up for a couple of drinks. And we came up with an idea of this thing called The Diary Of An Aspiring Dentist, whereas where I’d get to write a blog or articles for FMC on my experience where I’ve failed, things I’ve learned, because I was never afraid to talk about things I’ve failed.

Nik Sethi: And Sanjay always taught me that, we all mess up. I was going to say the F word there. We all mess up and you learn from it. So we did a series of articles on my experiences. And David gave me my first chance to give a composite lecture, which was horrible. Back in 2013, I tried to teach about 10 days worth in one day. And I look back at the lecture slides and they were awful, but you learn. But also how to talk to people, how to manage difficult conversations. I watched him when I’d help out on the stand for Optident, I’d watch him talk to dentists. How much is this? Without understanding what a product is. It’s like someone coming to you saying, “How much do you charge for your licence. Without understanding the story or the benefits or what it can do for your practise growth. You get these questions all the time. Learning-

Payman Langroud…: David’s influence on the profession. A lot of people don’t know him because in the trade, we all know him very well. But David’s influence on the profession’s being huge.

Nik Sethi: He’s amazing and he’s taught me a lot about people skills. So I owe him just as much as I owe Sanjay, Bazil and all the other people I mentioned as much credit and people don’t often get to trade enough credit. These are the people that teach us about materials that we use on a day-to-day basis.

Payman Langroud…: Yeah. That’s true. There’s a lot of information even from a salesman, who the receptionist is taught to keep away. Let’s talk pre-COVID when they used to actually visit. The nightmare the salesman has to just get his foot in the door is such a funny thing. Because the amount of information that’s in the salesman’s head about materials, about what’s coming next, about what other people are doing. It’s like free education you can get from a salesman. A lot of dentists spend their whole time keeping salesmen away because they think they’re being sold to. The best salesman, as you said, partners, aren’t they? The way you’ve just mentioned someone in the trade who has a massive influence on you. I like that. So now that you’ve bought in to the practise, how did that change your relationship with the team and with Sanjay? Is it basically that you’re now financially involved and everything stayed the same? Or did you actually make a change? To Sanjay, did you step back on some things and Nik took over or how’s that working out?

Nik Sethi: The buy in hasn’t completed yet for Square Mile as of now. It’s going to be soon. We completed on the [inaudible] one this week, the buy in is almost there. Essentially I, for the last-

Sanjay Sethi: I have stepped back in terms of running things because it’s not my bag. And he’s just literally for the last two years has put so much effort into the practise. So in [crosstalk 00:37:27].

Nik Sethi: I’ve treated it like I’ve been partner for the last few years, I’ve always treated like family. And I can say a lot of the team has been there for many years and they’ve known me since the kids. And it’s been easy in terms of getting them on board because it’s all running in Sanjay’s vision, but just bringing it forward to what I feel the practise could be to be able to be financially more successful, but also be doing more of the cases that we are known for doing and feel that we have the skills to do. And I think the team have bought into that new vision of pushing the practise forward of how special, the work we feel. And I do feel that some of the dentistry that we provide is life-changing. I know it sounds silly to say that, but I do feel that is, I’m very proud of that.

Nik Sethi: The work we put in, the blood, sweat and tears that goes into it, not just the dentist, but the nurses. I mean, Sanjay’s nurse Shaz. She’s like a second mum to me. She’s been there for 18 years. When she nurses with me, I’ll be doing preps on teeth, and I’m really tired and I’m not sure I want to prep the last two. And Shaz would kick me and look at me and say, “Go on. Carry on. We are two hours after the end of the day, she could easily be rolling her eyes. And yet she’s pushing me say, “No, come on. Your brother would finish it. You’re going to finish it.” It’s incredible the people we have around us.

Payman Langroud…: What about the thing, the tension between being the boss and being a friend and all of that?

Sanjay Sethi: I think really we’ve been, on balance, really good because we have our own strengths and yeah, there’ll always be some differences we’ll have along the way, and I’m not going to deny that. But on par, it’s sorted out on the day and we just move on. We have a laugh, we have a great time together. We enjoy each other’s company. He’s a crazy dude. This is my brother is just one Nutter. If you’re with him and it gets to midnight, trust me, his evening is just beginning. I remember once we went out and at the end of the night, I’m thinking, “Listen, it’s two o’clock. I’ve got to get back because I’ve got so much to do tomorrow.”

Sanjay Sethi: And it was like an old boys reunion with like say, Rob Beretti, some of the guys that you all know, we were all together. And he goes, “All right, no worries.” He goes, “Can you order an Uber?” And I’d never even used an Uber App. “I’m used to all this stuff.” He goes, “Don’t worry, I’ll order you something.” So he orders me an Uber. I get into this car. I didn’t know what the hell I’m doing. I’m just sitting there. And next thing I know, we’ve gone around the corner, we’ve picked someone else up. I’m thinking, “What’s going on?” He must’ve gone around East London to all these different estates. I thought I was going to get raped in the back of this car. Some of the people [inaudible 00:40:17]. I got home at six. And I’m phoning him, he left at five and he got home before me.

Nik Sethi: I got him an UberPool. I wanted to save about 10 quid.

Sanjay Sethi: [crosstalk] I don’t let him get me a cab anymore. Forget it.

Payman Langroud…: That’s funny man.

Sanjay Sethi: Yeah. We’ve had some good sometimes.

Payman Langroud…: You’ve had some good times, what about dark times Sanjay? In this evolution, there must’ve been some.

Sanjay Sethi: Oh, with me and Nik?

Payman Langroud…: No. In the practise-

Sanjay Sethi: Yeah. I’ve been really lucky in life that I’ve had fantastic parents. I’ve married my soulmate and she’s been a rock to me. I’ve got wonderful kids, wonderful family, wonderful friends. And so for me, when I look at dark times… I look at all the things that are around me, how dark is it really? And okay, we suffer for three months. We don’t get this. We don’t get that, but I’ve been blessed. So I can’t really complain. And if-

Payman Langroud…: What about COVID? And the fact that you’re in the city, has that been like a challenge?

Sanjay Sethi: It is ghost town around here. Fortunately we’re busy, people are coming in to see us. But it’s ghost town. If you walk around there, it’s airy. It’s picking up now that restaurants and bars are coming.

Payman Langroud…: But patients are still coming?

Sanjay Sethi: Patients are still coming. Yeah. Touch wood. Let’s hope so. [inaudible] right now,

Nik Sethi: It was a difficult year and difficulty for all of the profession, but especially in the run-up to COVID because we didn’t know about a fallow scheme in the beginning. The hardest thing about this all is trying to navigate the questions from the team, because it’s their livelihood. Luckily we’re in a profession where I’d like to think all of us have a little bit of a nest egg, that we have some savings that we can afford a couple of months if shit hits the fan. But a lot of our team aren’t maybe as fortunate. So having to navigate that situation where we were trying to talk about shorter working hours, it was tense times. And luckily with the fallow scheme, a lot of that was helped out.

Nik Sethi: Obviously, all practises didn’t get as much help as would have been nice from the government. But equally, as Sanjay said, it was a rare opportunity for us to look at the business about where we want to come back. And I was sure that I didn’t want to come back and I don’t want to compete with local practises. I don’t want to compete on them for times we take for treatment, for prices we take on treatment. I want to be like what Sanjay said, take the time we want to take, do the treatments you want to do, charge appropriately for that, and you look back and you see, “What patients do we want to treat in the practise? Do we want to see everyone and anyone or do we want to see the patients that value us? And obviously we value them.” So it was a nice time for us to reset and look at what type of practise do we want to be coming back after COVID.

Payman Langroud…: What would you pitch it, as far as the pricing, are we right at the top?

Nik Sethi: No, I don’t think so. We charge on an hourly rate, but I would like to be where, not necessarily top in Harley Street prices, but we’re certainly not cheap. The people could definitely go and get… And I always say to patients, “Don’t feel pressured by this plan. Go and get a second opinion.” Just like what you said Payman about going on different composite courses. I’ve always believed in planting the seed. I feel that we do one of the most comprehensive checkups around with-

Payman Langroud…: I had Coray on and he said he charges 400 pounds for the checkup and it’s a loss leader. He loses money on it.

Nik Sethi: I think we’re 120 and –

Payman Langroud…: It sounds beautiful. It sounds amazing. He really meant it. He really meant it. He was like, the amount of hours he puts in after that examination, that 400 pounds, he’s losing money. And so it’s really interesting because I don’t know, in an NHS situation, whatever, how much is that check up there? I don’t know. I have no idea. And you know, there were different outlooks on these. And then I remember as a dentist, the treatment plan numbers. I remember the first time I heard 20,000 pounds treatment plan. I couldn’t believe it was real.

Payman Langroud…: And then, first time I heard a 60,000 pound treatment plan, couldn’t believe that was real. And it just goes up and up. And it’s a funny thing because if I turned around and said, God forbid, that a family member’s ill, and it’s going to cost 80,000 pounds to get the best doctor to fix this person. A lot of people who even didn’t have the means would find the 80,000 pounds if they thought that that was the real situation. And so it’s funny because people who’ve got a bit of money, then we’ll certainly do it. Understanding that people value what you just said, about people valuing you.

Nik Sethi: Well, our ethos is a little bit different and this is where our associate, [inaudible 00:45:42]. But we have, I would like to thank especially Sanjay the skills to and that the cases to back up big plans, 30, 40, 50,000 pounds that Sanjay skills are incredible. And I’d like to think I’ve got a bit of experience myself, but we’ve always had this ethos that we will talk to a patient, look at what they can afford. And we don’t have to do all of that at once, you don’t have to just jump into a mega plan. We can get a plan that can get them stable for a few years, not kick the can down the road, but if we can improve them and get them stable, then if we plant that seed, when times are right, we can then go back to do a quadrant and then another quadrant. So we’ve never been the practise to turn over 50 grand cases. We’re the practise that will spend 15 years doing that case. I think that’s fair to say, isn’t it Sanjay?

Sanjay Sethi: Yeah. I’ve been there nearly 21 years, this January and that’s right. So you’re staging it, you get there, but it doesn’t sound… Again, I just did it my way. Is it ideal? No. But it’s got everyone buy in, you stabilise control, make sure and they know it’s part of the bigger picture.

Payman Langroud…: Sanjay, tell me about, you’ve been there for 21 years. Tell me about the thing Tiff talks about, about being in the same place for a long time being the best teacher of them all.

Sanjay Sethi: Yeah. I think it’s joy, but it’s also very painful sometimes to see some of your work.

Payman Langroud…: So tell me about that. Let’s talk about, we were asking everyone this question.

Sanjay Sethi: It’s really interesting because what I learned over the years, and that’s why I got involved with the teaching more and more, was the fact that it’s all great when you see these cases that have been done and you’ve got a week postdoc or six month post-op, but really if you’ve invested so much in your dentistry, even if you’ve just done one restoration, don’t you want it to look like that five, 10 years down the line? Ideally we know things are going to tie up, but we want to see can it last that long. And it’s those little nuances, those little things that you learn that can actually make things last, but it’s not every time. And I’d be lying to say that we don’t get failures or based on how you manage you failure.

Payman Langroud…: Can you give me a couple of examples of light bulb moments of something that you thought you did right 15 years ago, and seeing it now you realise that now you would do it differently because of seeing that ageing. Couple of examples.

Sanjay Sethi: My first one would definitely be at the beginning, probably a lot of the guys wouldn’t know this, there was this thing called Open Sandwich Technique with glass ionomers [crosstalk 00:48:21]. And there was some great guys that were advocates of glass ionomer like Jeff Light from Australia back then, but we were all taught, “Glass ionomer, glass ionomer.”

Payman Langroud…: This is a wonder because it realised fluoride, remember?

Sanjay Sethi: Yeah just fluoride everywhere. Well I’ve taken glass ionomer out restorations and there’s been carries underneath. So it’s not completely true. And I’m sure anyone that’s been around long enough would have seen that themselves. But I’ll tell you what, when that starts to go and ware, and you get the hygiene is scraping away at it because it feels rough after about five to seven years, it literally looks like another cavity underneath. See you’re back to where you started almost. Maybe you’ve got something sealed. But that was probably one of my light bulb moments when I thought, “Listen, if you’re going to do it, seal it all in.” I think the other thing was knowing the limits of what you could achieve with the material and then being the superhero idiot that I can be sometimes push those limits all the time.

Sanjay Sethi: And surprisingly, some of it just works like what Nik was saying, you take a case on, and back then we were doing direct… Well I was doing this before he was qualified, direct composite, full on lays and full teeth, almost like crowns in direct composite back in early 2000s and then using materials that getting better and better and better. And then eight to 10 years down the line, they’re still there. They don’t look as well polished, but they’re not really stained. And you’re thinking, “Did I do the wrong thing?” And then you’re seeing other people talk about it now. And maybe we were onto something back then, but I don’t think if I go back, would I want to do it all that way again? No, because I get a lot of backache because of it. It’s hard work.

Payman Langroud…: What about you, Nik? What’s the biggest clinical mistake you’ve ever made?

Nik Sethi: Wow. Many, first of all. And that’s why I always say when I’m teaching, and one of my mentor, Shane Gordon always said to me, “The minute you’re sweating, when you’re treating someone is when you’re out of control.” And believe me, I’ve spent a lot of time sweating in the last 10 years. It’s not necessarily a clinical, I’ve got lots of clinical examples, but one of the most recent ones was actually only about three, four months ago. It was a communication issue, which I took very personally because I’d pride myself from being quite good with my patients communication. And it was one of the times where I took my eye off the ball a bit and paid the price or lost the case.

Nik Sethi: And it was a patient referred to me where I’ve seen the rest of their family. I’ve treated his wife, I’ve treated the son and they all love the work I did. I’ve transformed their smiles, really got them happy with the dentist again when they’ve had terrible experiences. And so I saw this patient who didn’t have much of an aesthetic issue, but post-steria, he was in real trouble. His bite was collapsing, ware, clenching, fracturing everywhere. So his plan was actually a lot more complex and a lot more costly than the rest of his family’s.

Nik Sethi: And normally for every patient with a significant plan over a couple of thousand pounds, I will put together a PDF. I like to do a presentation. I do a zoom call. I put together the photos. I annotate them. I spend a lot of time in my free time doing this because I believe that no patient should start treatment with us until they fully understand what they need done. And with this chap, I was kind of going on holiday that week. And I said, “Okay, I’ll put the plans.” [inaudible] normal plan eight crowns, back, go do this to do that, however, many thousand pounds it was, and I just sent it.

Nik Sethi: And I had a chat with him and it was a really awkward chat because he said, “Oh, how did you just pluck this figure out of thin air? And what this you’re charging me, wants the provisional then charge me again for finals, is it because you like getting paid twice?” And at the time I was angry. I kept it together on the phone, but I was only thinking, “Do you know how much hard work this is going to take?”

Nik Sethi: And it’s only after I calmed down I realised I handled that totally wrong, totally wrong because I broke protocol. I pride myself on planting the seed and having as many interactions with that patient as possible, they call it touch points. Touch points, touch points, touch points, zoom calls, reviews, whatever it needs to be done. Let’s talk plan and see, if they go somewhere else and get it done. That’s fine. But at least they know what they need. And with this chap, I broke protocol. And actually it really ruined my weekend knowing that I didn’t communicate with this person as well as I could have done.

Nik Sethi: And it made me really reaffirm. And to all young dentist up there, I think a lot of the reason why there’s a lot of litigation of profession is communication. Clinical skills are one thing, but having that patient on the side from the beginning, if they know what to expect, they know why, they know the limitations. And they’re much more understanding when things do go a little bit pear-shaped. So that was bad. It really beat me up and I wish I handled that better.

Payman Langroud…: Sanjay, with your reputation, you must get that type of patient that turns up and says, “I know you’re the best.” And it’s always, I hear this a lot from people who’ve got big reputations, is that the patient turns up and starts picking them up. And it’s kind of like alarm bells, have you had many of those?

Sanjay Sethi: Because we’re not trained as psychologists. We’re not trained to spot it. We just want to do the work. We see the case and we literally want to get in there and do what we know we can do. And I think one thing that I’m still not the best at, excuse my French but it’s spotting a nut job. And I’m not the best at it because I just want to do the work and I know what I can achieve. I know what’s possible. And I set realistic aims for it, but sometimes it’s just never enough on a different level. I don’t-

Payman Langroud…: Sometimes the problem is psychological rather than physical if you just thought about it.

Sanjay Sethi: I really don’t spot it. Like he said, I bury myself into clinical and yet I love to communicate with patients. I love to get involved, but that kind of psychology, I just don’t spot it. I just literally just want to get in and do the work. I think I can help, that’s the way I look at it. And then like all of us as professionals, we can all help.

Payman Langroud…: Where’s this new practise you’ve bought?

Nik Sethi: We just bought a practise in Essex in Langdon Hills, which is a native Basildon. We bought that with a good friend of mine, Dev Patel, part of Dental Beauty Group. So looking forward to-

Payman Langroud…: Existing practise?

Nik Sethi: Existing practise, yes. Which is going to be a mixed practise. And our plan is to really bring that kind of Square Mile standard to Essex. I’ve always been asked by my mates, local, “When are you going to get a place in Essex?” And finally I thought, “Okay, this was the opportunity.” And I’ve known for a while now that for any associates out there that think owning a practise is easy, it’s not. Because since I’ve been part of helping out with the operations at Square Mile, and now at Basildon, it is a lot of work. And again, it’s like learning a totally new skill for me there, so I’m very excited about what we can bring to Essex, bringing that patient care. Even for NHS patients, we’ve made a protocol that our new patients are going to get a 45 minute examination, which is unheard of. So that we can explain to them what’s going on in their mouth, educate them, help them rather than patch them up, help them towards kind of a better future. And also-

Payman Langroud…: I didn’t know what you were going to do next year, but if I had to make a bet, I would have thought… Because you guys are real like homey. You were saying you both live one street away from where you grew up in Brentwood or where… Is it Brentwood? Near Brentwood.

Sanjay Sethi: It’s near enough.

Nik Sethi: Yeah. I live one mile from him and we live one mile together from my mum and dad.

Payman Langroud…: So I thought what you would do is go for one of these experiential squat jobs like get a warehouse and turn it into this unbelievable thing.

Nik Sethi: That would be the dream.

Payman Langroud…: Is that in the pipeline? [crosstalk 00:56:18]. A high risk idea.

Sanjay Sethi: We don’t have to blame you Payman.

Nik Sethi: The light bulbs are going. No. But the reason why I teamed up with Dental Beauty is because it allows me to be clinical director, bring in the clinical standards, teach the team, teach the dentists, and learn from them as well.

Payman Langroud…: No, no. Let’s look about my idea again. Let’s talk about-

Nik Sethi: Yeah. I will do it. One day I won’t do that.

Payman Langroud…: You know what I’m saying you’d do? Because Essex, there’s a kind of a can do. It’s what I love most about Essex. It’s like the America of Britain. There’s kind of a can do, is going to happen. Let’s just do it.

Sanjay Sethi: It is [crosstalk] and people want to have good stuff and they’re not [crosstalk 00:57:07].

Payman Langroud…: You want to try new stuff.

Sanjay Sethi: Yeah, they like it.

Payman Langroud…: Everyone’s a bloody property developer builder type. Like if you wanted to make something extraordinary inside this book, I don’t know if you’ve seen Robbie’s place in Liverpool. Like he’s done that. It’s a box. On the outside it’s just a box and then you go inside and it’s like, “Whoa.” [crosstalk 00:57:28]. You should do it man.

Nik Sethi: Great. Next time we meet mate, you’re going to be like-

Sanjay Sethi: Stop giving him ideas. He’s going [inaudible] with ideas. I haven’t got enough time in the day to keep up with him. Please don’t give him anything else right now.

Nik Sethi: I’m so terrible. I like it. One day let’s see what happens.

Payman Langroud…: Tell me about your situation as far as family, kids and all that. Sanjay, you’ve got a couple of kids, have you?

Sanjay Sethi: Yeah. I have. My son has just, unfortunately he didn’t get to celebrate his 18th birthday. That happened last month because it was in lockdown. So I felt really sorry for him, but he’s a really good lad. He’s the Apple of our eye. And then I got my daughter and again-

Payman Langroud…: Are they going to be dentists?

Sanjay Sethi: No. They just look at me and say, “Dad, you work too hard. We don’t want to do that.” He wants to go into economics and finance. I don’t think he knows what’s going to hit him. But that’s [crosstalk 00:58:15]. He’s good at all of that sort of stuff.

Payman Langroud…: And your daughter?

Sanjay Sethi: She’s 12. We still see her as baby. She’s creative. She likes drama and she’s sort of just finding her way. So yeah, she’s still daddy’s girl, which is great.

Payman Langroud…: And what do you do? Do you work five days or less than that?

Sanjay Sethi: I’m four days now. And actually that was Nik. So that’s actually… Nik had a great influence in trying to make my life a bit easier. And then when he sees that I have a gap in something, then he’ll give me something else to do. He’s quite quick to find me something to do, to be honest. But it’s all good. I like the-

Payman Langroud…: Have you gotten on with the whole digital, I’m not talking Instagram, I’m talking digital dentistry scanners? Because I saw that stuff you sent me was with… Was that [inaudible 00:58:58]?

Sanjay Sethi: That probably was done an extra cat by the lab. I’m still learning it. I think I’m still finding my feet with it. I’m getting better and better at doing the actual scanning and procedure. It does take a bit of time to understand it, the limits of where you can push digital dentistry. I’m still not so comfortable. The problem is when you’ve got this old school technique that just works really nicely, it just becomes difficult to switch. And when you do push it and it doesn’t work rather than [crosstalk 00:59:30], “Let’s do it this way.” I just go back and then I have to literally get-

Payman Langroud…: I was exactly the same thing with Nik CEREC, it was in the powder days where it wasn’t very good. But I remember thinking, I’ve got something that I know how to do. It’s fully predictable, an inlay prep or whatever inlay. And then I’m doing it with steric and it’s introduced all this unpredictability into it. And like you said, unless you… There’s a kind of, Andrew Dogwood was calling it the technology chasm. You get into something new and then you think, “Oh, what the hell did I do?” And like you said, you’ve got to go through that. And like you said, it takes energy.

Sanjay Sethi: I’m getting there. I’m always a bit tentative, but I’m doing it more and more. I found that some techniques, interestingly enough, like implant impressions, the technicians with who I work with, I work with some fantastic technicians. They prefer-

Payman Langroud…: Who are they?

Sanjay Sethi: Sorry, who are they? One is called… Well, I’ve got a number of them. Daniele Rondoni I’ve got Eva Force at fusion. There’s Eddie Marker. There’s a number of technicians that I worked with over the years. And I’m sorry if I’ve forgotten anyone else at the moment, but they actually still prefer with certain things like soft tissue work to have it on a stone model rather than doing it from digital and they can manipulate things a bit better. So maybe that’s their understanding. Maybe that’s the way that I’m expecting things of them. I don’t know. So haven’t quite found my feet, but actually to me it’s quite impressive going back to CEREC. I’ve seen patients with CEREC restorations over 20 years old in their mouth. They don’t look pretty. I’ll be honest, but they’re working.

Payman Langroud…: 20 years ago, [inaudible] as well. Nik.

Sanjay Sethi: Yeah. [inaudible] Payman.

Payman Langroud…: I wish. Nik what about you as far as digital? Are you digitally native or you just take too easily.

Nik Sethi: No, I don’t think I am. I’m really enjoying the scanning side of things. I never loved taking impressions, I guess because I knew scanners were already available when I was in-

Payman Langroud…: [crosstalk 01:01:37], guys?

Nik Sethi: Yeah. We’ve got the TRIOS 4 four. And at the new practise we’re going to have the CEREC [inaudible 01:01:45]. So we’re going to have [inaudible] and CEREC going as well. I really love the fact that I have to take impressions. I just think that’s such a patient centred-

Payman Langroud…: It goes way beyond that, doesn’t it? It’s not just about the gap, it’s everything else.

Nik Sethi: Well, actually the communication with the lab is fabulous. I really do enjoy the fact that I can get that digital design. I agree with Sanjay, at some phase that when things are working so well with someone like Eva Force from fusion who is phenomenal. When her wax ups were coming back, stunning, handmade racks ups, you can’t get that on a computer. And if you do get it on the computer, you certainly won’t get it when they print it. So it’s not that same level to that end degree, but it has made communications so much quicker. And even from clinically, the fact that you can just scan and check your clearance. Because one of the things I always make a mistake when you ask me about clinical mistakes, I always used to under-prep the occlusal surface for [inaudible] in the-

Payman Langroud…: That’d be so minimal, right?

Nik Sethi: Yeah, exactly. So I’d always end up having these ultra thin on lays sent back or having reduction [inaudible] that I don’t have to manually correct. Or getting the patient back for an adjustment. So being able to just check your clearance and go again, for me has been a real triumph for me. But I wouldn’t say I’m the quickest at getting adapt to all the new smart design stuff that’s coming out around 10 years in. I’m not old. I am a little bit old school.

Sanjay Sethi: I like waving a wand and then looking at the patient go, “Wow.” And then thinking… This is so great. You’re just literally showing them it. And they’re just literally like putty in your hands when they’ve seen it. When all the other stuff that I did for the years meant nothing to them just by seeing their teeth in a digital format.

Payman Langroud…: I think a mistake some dentist make though on the communication side, you know this thing you were saying about Basil and it’s never right. And all of this, I’ve seen this happen before. Some young dentists and particularly some very good dentists. When they’re looking at the work on the patient, they start talking in that way and for the patient, the patient doesn’t see that as a top dentist being hyper-critical. The patient sees that as, “What did you say is wrong with it?” Between us, we understand. If I’m this hyper-critical [inaudible 01:04:11], “It could be just a little bit better.” We get it right. But when you’re a patient, you put yourself on the patient’s position, but then she’s just looked at it and instead of going, “Wow, it’s amazing. I’m really happy with that.” He’ll go. “Yeah. I’m happy with it. I’ll be even happier if X, Y, or Z.” And the patients then thinking, “Well.”

Sanjay Sethi: Where we qualified back then, if you told patients they needed six crowns, they go, “Yeah. All right, let’s do it.” Now you have to justify everything. Show them, take pictures and everything. It’s all different. Now. Because they don’t trust dentists and doctors like they used to.

Payman Langroud…: Quite rightly. Yeah. The world’s better in that respect. You know one thing that is interesting for me, when we talk about bedside manner, chairside manner, and soft skills and hard skills. And we got to a situation my wife needed an operation and we were trying to choose the right surgeon for the job and crazily bedside manner. The manner of the surgeon was probably the most important thing in deciding which surgeon to go with. And it’s counter-intuitive, because you’re thinking from our perspective, you want the hands and the eyes and the brain. And yet the guy who was most understanding was the one we went with.

Sanjay Sethi: He might have not been the best, or she might not be the best-

Payman Langroud…: Yeah, he might not have been the best. The prickly one might have been the-

Nik Sethi: You reminded me of a great story. Someone we know I won’t mention the name or where they were, someone we know years ago told us of a story where they were doing an endo and the file fractured down a root canal. And they sat the patient up and they said, “You know these files we used, they’re handmade in Switzerland with the highest technology of steel. And they’re designed to be hard as they’re so strong. Your teeth have such an incredible shape on them. Amazingly, that file fractured. And you know what the patient turned around and said?

Payman Langroud…: Separate it.

Nik Sethi: She said, “I’m so sorry that I did that. Do you want me to pay for the file?” Can you imagine now someone like me I’d get slapped around the face. It’s ridiculous.

Payman Langroud…: I have to pay for the endodontist to get the fractured file out. I’ll remember that.

Nik Sethi: We’re not mentioning where they worked, remember.

Payman Langroud…: So we’ll need to get from both of you, a couple of predictions. Predictions, as far as clinically, what’s going to be hot? Where do you see clinical dentistry going? Whichever way you want to say that? Are we talking short-term or go bizarre and tell me what things will be like in 50 years time, if you want. Whatever you like. And number two, as far as the dental world in the UK, what are your predictions going forward? Like let’s not leave that 50 years. Let’s call that, next year.

Nik Sethi: I’ve got a good and bad prediction. A good prediction, I think that we’re not allowed with the whole COVID thing with the whole aerosol risks, I think the quality of adhesive dentistry is going to go through the roof because more dentists than ever now finally have a good excuse to use rubber dam. So I think we’re going to see less composites failing. And when I’ve been teaching recently, a lot more dentists that weren’t using rubber dam recently were over that Hill, as you know Payman, it’s just practise, practise, practise. It’s not rocket science.

Nik Sethi: So forgetting all the digital stuff and all the things that are going to be incredible, I think going back to building blocks, which is what you probably gathered me and Sanjay are all about. I think basics are going to improve. I think finally, we’re going to lose this amalgam mentality of GV black cavity preparations. I think finally people are going to embrace these open infinity margin preparations rounded, composite doesn’t want a margin. I think isolation is going to be a big deal. And when the bonding Asia is getting so versatile with these universal bonding agents, I think we’re going to see these adhesive restorations finally achieving in everyone’s hands what amalgam did over the next few years, which will be amazing. They may not last as long, but they’re certainly much less harmful to the teeth in the longterm. That’s my hope anyway.

Sanjay Sethi: Yeah, I just think that dentistry is becoming faster and faster, more and more efficient. And sometimes maybe we’re forgetting basic principles, especially with things like implant dentistry. Some teeth are being taken out where they could have been saved. And it’s a bit sad to see it because, if you’ve got someone that’s in their 40s and could live into their 90s to a 100s, they could’ve kept teeth for another 15, 20 years, maybe even 30 years. I’ve seen really great perio and teeth lasting. And I just think biology takes time. If you can save teeth first, you can stabilise, then you’ve got a chance to reassess. But people want to go in fast, fast, fast, and see results.

Sanjay Sethi: And I think on the one hand, that’s great business, it’s great money, but it’s almost like the old school ethos. I think that’s where dentistry is changing. It’s become more from my point of view, maybe from what I’m seeing it’s more business orientated and maybe the healthcare side of things, the love, that little part that was actually very important to some of the old school generation is changing or has changed because business, marketing, speed, efficiency, profit timelines, everything has just become more important.

Payman Langroud…: So that’s a bleak future analysis.

Sanjay Sethi: Not really because if you find the right people and there are a lot of good people out there as well. It’s like any profession, there are good accountants, there’s bad accountants. It’s like in any profession, there are a lot of good people out there that have good ethoses and work hard. So I think that’s not bleak. I still think it’s just a case of finding someone that is prepared to take the time. And are you prepared to spend that.

Payman Langroud…: I fully agree with both of you about the basics. Just in a little bit of dentistry that I know something about bleaching all about the basics. Get a good impression, you’d be amazed the number of poor impressions that come in for enlightened. A large number of poor impressions come in. Just that, start with that.

Sanjay Sethi: I was thinking, another 30 seconds of putting the impression-

Payman Langroud…: It makes a massive difference to the results. And then you go to the next bit, understanding the basics is really a key, key, key thing. You’re absolutely, absolutely right both of you. What about for the profession as far as NHS private, what’s going to happen next? What are going to be trends? What’s caught your eye? I’ll tell you what’s caught my eye and it goes opposite to what you guys are saying. This story with digital and the idea that we can take the dentist variable out of the equation and have a system that anyone can use. Like what’s happened with Invisalign and we all know that you still need to know what you’re doing when you’re using Invisalign. But that idea that the system can take over. What’s the name of the… Sorry man. It’s late on a Sunday.

Sanjay Sethi: [crosstalk] diagnosis and all of this sort of thing, everything in digital in that way?

Payman Langroud…: Yeah. For instance, the avant-garde with Robbie. Robbie’s whole idea is that the dentist skills should be minimum and the system should be able to make it so that the dentist skill is minimum in it. And he’s right, if you’re looking for that, it’s the notion that a big Mac is a big Mac in Moscow as it is in Tehran, as long as the formula is the same.

Nik Sethi: It’s really funny you say that. And I can’t tell you where I was or the company that it was for because I have signed an NDA. But I saw this most incredible robotic arm, which is totally pressure sensitive when you’re moving it. And you can push it fast, you can push it slow, and it’s totally adapted to what you’re doing. And it’s like a dead straight surveyor. You imagine prepping with something that is dead, accurate, everything around. And I think just like we have done with the hair transplant industry, these machines that just come in, we all know where this is going.

Payman Langroud…: Touch your hair then Nik.

Nik Sethi: Yeah. Well, you never know. I am feeling a little bit, but I have to say, we know where this is going. What I saw in that robotic arm was incredible. And you think for dentists-

Payman Langroud…: Why should a dentist hold a drill, man? But that’s really one.

Nik Sethi: In one way, I love this whole thing of the geeky science and how things work. But in the other way, I don’t necessarily think… There’s a lot of people out there that think you have to be able to layer in 50 layers. You have to know how to put these translucent bits in with your hand. You have to be able to manipulate composite in a way, and you’re thinking, “Well, if I have something that could do that bit for me but I was still prescribing it and diagnosing it properly and getting a result, I couldn’t achieve freehand. Am I doing anything wrong for the patient? I think we’ve got to drop our egos and accept that things are going to very much change.

Payman Langroud…: Have you seen that DSD thing where they make a prep [inaudible 01:14:00]?

Nik Sethi: Yeah. And the veneers are pre-made. We saw that in Poland. Sanjay and I lectured at the-

Sanjay Sethi: Well, I think what’s possible is incredible. And once it becomes mainstream, you’re absolutely right Payman. If it takes that level of skill as expected out of the dentist away, but then they’re able to achieve the same, actually they’ve done the profession a favour, haven’t they?

Payman Langroud…: But see along the way, there will be pitfalls just like the sandwich technique, the glass ionomer, just like composite, when it first came out, Sanjay, you remember. Posterior composites were a disaster.

Sanjay Sethi: You didn’t use them.

Payman Langroud…: Not when they first came up. But when people first started doing posterior composites, it was disastrous what was beaming. So there will be errors along the way. There will be pitfalls like Smile First, it’s amazing the way that the market’s taken that up.

Nik Sethi: What’s funny is that I-

Sanjay Sethi: It’s the same reason. It’s the same reason that the system can take over where the artistry of the dentist isn’t as important anymore.

Nik Sethi: We both know [inaudible] really well. Actually, I feel sorry for some of the backlash that he was getting on Facebook totally unfair by some prominent minds that I won’t mention.

Payman Langroud…: Did he get backlashed?

Nik Sethi: Yeah. Because they were like, “This is taking the R out of it. You’re layering composite over the two, you’re doing this.” You’re thinking, “Well, people are doing freehand five to five, horrendous, direct composite veneers out there at the moment. But if you can systemize, as they’re getting a beautiful result in a predesigned manner, that’s easy to replicate and less likely to fail then it’s going to help raise the general level of dentistry. There’s always going to be the depression. There’s always going to be the me, the science, think of in the past, we’re always going to want to do things to that next level. But if we, as a collective and systems like Smile First can raise the level of UK dentistry as a general like Bioclear for example, and other companies, I think actually it’s a good thing.

Payman Langroud…: If they can, right? If they can. That’s a key point. You’ve got the long-term implication. This is what I’m trying to say, we don’t know, do we? And by the way, we didn’t know with Enlightened, right we said, we’re going to make bleaching better. That by itself was a big thing to say, but we were going to make it better. We didn’t know long term there was going to be problems or not. We didn’t know for sure. You’re trying your best to do everything right. But it’s funny the tension between progress and doing things exactly the same as they’ve always been done. And I was talking to Tiff about this as well, would he have even bothered doing all the work he did in the current GDC environment? The risks.

Nik Sethi: I was talking to two young dentists I’ve just taken on for basil them. And they’ve missed out a lot because of COVID in a time where it’s so important to have the experience, you just learn your hand skills. And a lot of that’s been robbed from them and it’s scary, they’re scared shitless of what they’ve got to now jump into because now it’s the real world. They haven’t got demonstrators checking what they’re doing. They haven’t got a mentor over their shoulder for every single case. And litigation’s at an all time high. So for the younger generation is very, very scared. And I really do feel for these FD dentists that I’ve been training a lot recently. And this, again, comes right back to where we started this whole thing today about surrounding yourself with an Academy, whatever it may be, Bart, BACD, therapist academies, something that makes you feel safe and a camaraderie to be able to discuss your failures and learn quick. Because if you don’t learn quick and you’re already lacking experience, it’s trouble.

Payman Langroud…: I know you guys are so humble, you’re not even pushing your own boat up, but tell us a bit about this Aesthetic. Do you call it Aesthetics?

Nik Sethi: Aesthetics. That’s all training we do under-

Sanjay Sethi: [crosstalk] say it properly Nik, Aesthetics.

Nik Sethi: Aesthetics. But Sanjay and I, we’ve been doing this for a little while. And as you know, you generously supported us with [inaudible] last year, it was fabulous. We ran 10 days. We became really close with another fabulous clinician, Riaz Yar, who is just one of the most prominent minds in UK dentistry. Just takes understanding to another level. He’s finally made me understand occlusion, and if I can understand occlusion, then we all can. So we’ve teamed up with Riaz to start a company called Elevate Dental and essentially that’s Aesthetics and Riaz together. And we’re going to be doing online education, which we’ve already had recorded. We’re going to update short courses on minimal prep onlay preparations, which I’ve been doing a lot of. And Riaz’s talking about simple occlusal assessment with onlay preparations. Sajay is going to be doing a two day course with Riaz on vertical preparations and occlusion.

Nik Sethi: And then we’re also releasing next year, a two year diploma, which is going to be down South with Dental Beauty Dentists, and then up North, we’re going to be running it in collaboration with a Smile Academy. So there’s some really exciting things going on behind the scenes, that I can’t wait. There’s a lot of hard work, but I’m putting into it with many others. But again, it comes back to what we said that we love being able to inspire the younger generation to be as lucky as I have been to have people like Sanjay around me. And if I can be part of their journey to improve, then I will be over the moon and surrounding ourselves with wonderful people like Sanjay, Riaz, Depeche, Elaine, Amit, yourself. I do think we’ve got some fantastic people in this profession. So I do think despite challenges ahead with good minds together and good opportunities, I think there’s going to be some exciting times for young dentists going forward.

Payman Langroud…: Prav is not here, but I don’t know if you listened to this show Sanjay. Prav, he likes to end it with a particular question and it’s funny we got some feedback on it. Someone said, “I don’t like this question because it mentions death.” But the question is, if you’re on your death bed and you’ve got your family around you, what are three pieces of advice that you’ll leave?

Sanjay Sethi: Nik, you go first. On the death bed? I don’t remember that being a question.

Nik Sethi: On my death bed, that’s really tough. I would say, don’t be afraid of being wrong. I feel like I wasted a few years just following the status quo, doing whatever Sanjay said, whatever [inaudible 01:20:52], and I maybe stifled myself with starting the education company today a bit later than I would have wanted to. Don’t be afraid of being wrong and making new challenges. And if you fail, get up and go again. Knowing your limits clinically. In life, just knowing your limits and being prepared to take on challenges when you’re genuinely ready to. Don’t just do it because you think you can, because you can fail very quickly and very hard.

Payman Langroud…: Those two are in opposition with each other there, isn’t it? Don’t be afraid of being wrong. [crosstalk] I like it.

Nik Sethi: I felt I was ready to start an education company a few years ago, but I stopped because I was worried I was too young and people wouldn’t take it right. Like, “Oh, who are you Nik? You’re only 30 years old.” So I don’t mean it in terms of don’t do stuff. I mean, take on a new challenge when you know you’re ready, but know your limits of what you can do. Like the few speeches you hear from, one out of Denzel Washington have dreams, but make sure you have goals because dreams without goals are just dreams. And I love that saying.

Payman Langroud…: And what’s the third one?

Nik Sethi: Have a laugh all day. Sanjay and I have always done that. We have a few drinks. We have a good time and we know when it’s Friday night, we put everything else aside, just switch off, enjoy with your loved ones. I’ve got a beautiful wife who I cherish more than anything. Beautiful family, love my niece and nephew, just have a blast while you’re doing to, COVID for, everyone’s been a stressful year. But for me, honestly, financially aside, which is a bit crap, I probably had the best year of my life. I learned to cook. We made a stupid song, Raving in Lockdown, which was-

Sanjay Sethi: That was good [crosstalk 01:22:40].

Nik Sethi: We had such a laugh drinking in each other’s gardens and zoom calls. And just spending time at home, spending more time interacting with the parents and stuff. Just put your phones away every once in a while, get digitally disconnected and go back to the roots, get bored. I remember being young and wondering, we had four channels on TV and Sunday used to last forever. I remember sitting there thinking, “Well, when is this day going to end?” Now, I don’t know where the year goes, let alone the day. Unplug make yourself bored every once in a while and enjoy that feeling.

Sanjay Sethi: That was good.

Payman Langroud…: Sanjay?

Sanjay Sethi: All right. So I’d say it’s got to be a little bit dentistry related, but it’s still alive. I’m no Dalai Lama, but I’m just saying in terms of dentistry and profession, I think patience and perseverance. If I could say to anyone who’s young and in dentistry, even at-

Payman Langroud…: In any endeavour.

Sanjay Sethi: Patience and perseverance, take your time and enjoy the ride. I think that’s really important. That’d be my first one. Second one would be hindsight is a really powerful thing and it’s easy when someone says, “What would you go back and change if you were on your death bed?” Well, nothing really. Because that was all part of your learning experience, which puts me down to this one saying that I gave my kids and my son wrote it on his wall. Knowledge is nothing without application. It doesn’t matter what you’ve learned. You can have all these facts in your head, but if you can’t apply it, whether it be in dentistry in life, life lessons, whatever it meant, nothing did it? And you don’t want to be sitting there full of regrets. So you’ve got to apply it and evolve all the time. And third one, I agree with Nik. And again, I say this to the kids all the time, life is all about moments and making them so go out there and go and have them enjoy it.

Payman Langroud…: I like that buddy. And how would you like to be remembered?

Sanjay Sethi: Just a great guy and great friend. I think that was what I’d love to be remembered for. I think that would be the way you want to be in someone’s heart, not just for doing a great composite. What’s that?

Payman Langroud…: Nik?

Sanjay Sethi: Make a difference.

Nik Sethi: I think just a similar of having energy. Have energy, just do things. Whatever your dream may be, I always did things in my life with a lot of energy. So I’d like to just be remembered the guy that had a lot of energy really.

Sanjay Sethi: He’s definitely got that, trust me.

Nik Sethi: The Duracell Bunny.

Payman Langroud…: It’s been lovely having you guys on. Thank you so much, guys.

Nik Sethi: Thanks so much.

Sanjay Sethi: Thanks so much.

Payman Langroud…: Take care.

Nik Sethi: Cheers. Bye-bye.

Payman Langroud…: Bye-bye.

Speaker 2: This is Dental Leaders, the podcast where you get to go one-on-one with emerging leaders in dentistry. Your hosts, Payman Langroudi and Prav Solanki.

Nik Sethi: Thanks for listening guys. If you’ve got this far, you must have listened to the whole thing and just a huge, thank you both from me and Pay for actually sticking through and listening to what we had to say and what our guests has had to say, because I’m assuming you’ve got some value out of it.

Payman Langroud…: If you did get some value out of it, think about subscribing. And if you would share this with a friend who you think might get some value out of it too. Thank you. So, so, so much for listening. Thanks.

Speaker 2: And don’t forget our six star rating.

 

 

Since launching the show way back in June 2019, we’ve had the privilege of chatting with some of dentistry’s most inspirational figures. 

In this week’s new-of-year special, we look back on some of the best answers to Prav’s final questions on legacy and advice for the next generation.

Kicking off with the legendary, late Anoop Mani we’ll hear words of wisdom from the dental leaders who’ve made the show possible over the past year.

Enjoy!